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NPI Code Detail

MEDICARE: DR. WANDA MILLNER WILLIAMS PHD, RN, WHNP

MEDICARE: DR. WANDA MILLNER WILLIAMS PHD, RN, WHNP
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
1363LW0102XWomen's Health Nurse Practitioner26NJ00504800NJ
2363LW0102XWomen's Health Nurse Practitioner940025NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1730229535
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WANDA MILLNER WILLIAMS PHD, RN, WHNP
Provider Business Mailing Address
First Line : PO BOX 22581
Second Line :
City : NEW YORK
State : NY
Zip : 10087-2581
Country : US
Telephone Number : 856-669-6050
Fax Number : 856-528-3117
Provider Business Practice Location Address
First Line : 317 S BROADWAY
Second Line :
City : CAMDEN
State : NJ
Zip : 08103-1209
Country : US
Telephone Number : 856-365-3519
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2007
Last Update Date : 04/12/2021

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