Provider Demographics
NPI:1134476021
Name:WILLIAMS, SUSAN PRATER (NP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:PRATER
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:PRATER
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:300 20TH AVE N
Mailing Address - Street 2:9TH FLOOR
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2131
Mailing Address - Country:US
Mailing Address - Phone:615-284-1400
Mailing Address - Fax:615-284-1693
Practice Address - Street 1:300 20TH AVE N
Practice Address - Street 2:9TH FLOOR
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2131
Practice Address - Country:US
Practice Address - Phone:615-284-1400
Practice Address - Fax:615-284-1693
Is Sole Proprietor?:No
Enumeration Date:2012-08-09
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16898363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4339141OtherBLUE CROSS-BLUE SHIELD
TNP01115411OtherRR MEDICARE
TN1530530Medicaid
TN4339141OtherBLUE CROSS-BLUE SHIELD