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NPI Code Detail

MEDICARE: MS. DIANE MARIE WILLIAMS NURSE PRACTITIONER

MEDICARE:  MS. DIANE MARIE WILLIAMS  NURSE PRACTITIONER
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 Practitioner4704182695MI

General Provider Information

NPI Number : 1760608772
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DIANE MARIE WILLIAMS NURSE PRACTITIONER
Provider Business Mailing Address
First Line : 7110 STADIUM DR
Second Line :
City : KALAMAZOO
State : MI
Zip : 49009-9423
Country : US
Telephone Number : 269-372-7600
Fax Number : 269-372-7604
Provider Business Practice Location Address
First Line : 7110 STADIUM DR
Second Line :
City : KALAMAZOO
State : MI
Zip : 49009-9423
Country : US
Telephone Number : 269-372-1200
Fax Number : 269-353-4860
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2007
Last Update Date : 03/30/2016

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Directions to “ MS. DIANE MARIE WILLIAMS NURSE PRACTITIONER” Practice Location

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