MEDICARE: HOLLIE WILLIAMS PMHNP LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	261QM0850X	Adult Mental Health Clinic/Center
3	261QM0855X	Adolescent and Children Mental Health Clinic/Center
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1649067281
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLLIE WILLIAMS PMHNP LLC

Provider Business Mailing Address
First Line	:	800 N 6TH ST
Second Line	:
City	:	HIAWATHA
State	:	KS
Zip	:	66434-1717
Country	:	US
Telephone Number	:	785-741-3633
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 N 6TH ST
Second Line	:
City	:	HIAWATHA
State	:	KS
Zip	:	66434-1717
Country	:	US
Telephone Number	:	785-741-3633
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	HOLLIE M WILLIAMS
Credential	:	APRN
Telephone Number	:	785-741-3633

Provider Enumeration Date	:	04/24/2025
Last Update Date	:	06/03/2025

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