MEDICARE: SHEILA 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	363LA2200X	Adult Health Nurse Practitioner	12568	TN
2	163WG0100X	Gastroenterology Registered Nurse	RN0000116000	TN

General Provider Information

NPI Number	:	1609922327
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEILA WILLIAMS

Provider Business Mailing Address
First Line	:	705 N HIGH ST
Second Line	:	SUITE A
City	:	MORRISTOWN
State	:	TN
Zip	:	37814-3876
Country	:	US
Telephone Number	:	423-587-0860
Fax Number	:	423-289-1267

Provider Business Practice Location Address
First Line	:	705 N HIGH ST
Second Line	:	SUITE A
City	:	MORRISTOWN
State	:	TN
Zip	:	37814-3876
Country	:	US
Telephone Number	:	423-587-0860
Fax Number	:	423-289-1267

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

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	09/13/2012

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