MEDICARE: MORGAN NELMS WILLIAMS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN265308	GA
2	363L00000X	Nurse Practitioner	RN265308	GA

General Provider Information

NPI Number	:	1437779436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MORGAN NELMS WILLIAMS

Provider Business Mailing Address
First Line	:	1015 DUTCHMAN RD
Second Line	:
City	:	GRIFFIN
State	:	GA
Zip	:	30223-6667
Country	:	US
Telephone Number	:	678-967-1961
Fax Number	:

Provider Business Practice Location Address
First Line	:	874 LANIER AVE W STE 220
Second Line	:
City	:	FAYETTEVILLE
State	:	GA
Zip	:	30214-7659
Country	:	US
Telephone Number	:	678-833-1444
Fax Number	:	678-833-1445

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2020
Last Update Date	:	01/07/2021

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