MEDICARE: GAIL WILLIAMS-BOOKER FNP-C

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	363LF0000X	Family Nurse Practitioner	5009882	NC

General Provider Information

NPI Number	:	1568971083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GAIL WILLIAMS-BOOKER FNP-C

Provider Business Mailing Address
First Line	:	333 COMMERCE ST STE 700
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37201-1835
Country	:	US
Telephone Number	:	615-454-9850
Fax Number	:

Provider Business Practice Location Address
First Line	:	615 SAINT GEORGE SQUARE CT STE 300
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27103-1368
Country	:	US
Telephone Number	:	336-793-8125
Fax Number	:	855-737-5542

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

Provider Enumeration Date	:	09/27/2017
Last Update Date	:	09/27/2017

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