Provider Demographics
NPI:1043594369
Name:WILLIAMS, TAMMIE ANN (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:TAMMIE
Middle Name:ANN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 CHEROKEE RD
Mailing Address - Street 2:PO BOX 203
Mailing Address - City:THOMASTON
Mailing Address - State:GA
Mailing Address - Zip Code:30286-3402
Mailing Address - Country:US
Mailing Address - Phone:706-647-3200
Mailing Address - Fax:706-647-2346
Practice Address - Street 1:202 CHEROKEE RD
Practice Address - Street 2:
Practice Address - City:THOMASTON
Practice Address - State:GA
Practice Address - Zip Code:30286-3402
Practice Address - Country:US
Practice Address - Phone:706-647-3200
Practice Address - Fax:706-647-2346
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-05
Last Update Date:2011-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN136002363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner