Provider Demographics
NPI:1114152063
Name:WILLIAMS, JEAN (FNP)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7436
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93290-7436
Mailing Address - Country:US
Mailing Address - Phone:559-622-8500
Mailing Address - Fax:559-622-9410
Practice Address - Street 1:5533 W HILLSDALE AVE
Practice Address - Street 2:SUITE C
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-5138
Practice Address - Country:US
Practice Address - Phone:559-622-8500
Practice Address - Fax:559-622-9410
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-21
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP180366363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner