MEDICARE: MRS. ZINA 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
1	163WH0200X	Home Health Registered Nurse	RN269995	OH
2	363LP2300X	Primary Care Nurse Practitioner	APRN.CNP.019822	OH
3	363LF0000X	Family Nurse Practitioner	APRN.CNP.019822	OH

Other Identifiers

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

General Provider Information

NPI Number	:	1891913000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ZINA MARIE WILLIAMS NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	425 W GRAND AVE STE 3003
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45405-4722
Country	:	US
Telephone Number	:	937-294-3603
Fax Number	:	937-294-3612

Provider Business Practice Location Address
First Line	:	425 W GRAND AVE STE 3003
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45405-4722
Country	:	US
Telephone Number	:	937-294-3603
Fax Number	:	937-294-3612

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

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	10/14/2024

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Directions to “ MRS. ZINA MARIE WILLIAMS NURSE PRACTITIONER” Practice Location

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