MEDICARE: KATHERINE DENESE WILLIAMS APRN

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	APRN11038088	FL

General Provider Information

NPI Number	:	1871392316
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE DENESE WILLIAMS APRN

Provider Business Mailing Address
First Line	:	PO BOX 102222
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30368-2222
Country	:	US
Telephone Number	:	239-274-8200
Fax Number	:

Provider Business Practice Location Address
First Line	:	795 SW STATE ROAD 47
Second Line	:
City	:	LAKE CITY
State	:	FL
Zip	:	32025-0453
Country	:	US
Telephone Number	:	386-401-7066
Fax Number	:	833-933-0709

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

Provider Enumeration Date	:	03/10/2025
Last Update Date	:	01/26/2026

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