MEDICARE: MICHELLE MCWILLIAMS 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	307957	AZ

General Provider Information

NPI Number	:	1578303319
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE MCWILLIAMS FNP-C

Provider Business Mailing Address
First Line	:	1415 S MERIDIAN RD
Second Line	:
City	:	APACHE JUNCTION
State	:	AZ
Zip	:	85120-8471
Country	:	US
Telephone Number	:	480-313-1737
Fax Number	:

Provider Business Practice Location Address
First Line	:	4365 E PECOS RD STE 113
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85295-7888
Country	:	US
Telephone Number	:	480-313-1737
Fax Number	:	602-922-1920

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

Provider Enumeration Date	:	05/29/2024
Last Update Date	:	10/26/2025

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