Provider Demographics
NPI:1164293148
Name:WILLIAMS, JAMES DARNELL JR (FNP-C, MSN, RN, CEN)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:DARNELL
Last Name:WILLIAMS
Suffix:JR
Gender:M
Credentials:FNP-C, MSN, RN, CEN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2429 OHARE CT
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL
Mailing Address - State:CA
Mailing Address - Zip Code:92251-9004
Mailing Address - Country:US
Mailing Address - Phone:760-540-0053
Mailing Address - Fax:
Practice Address - Street 1:2429 OHARE CT
Practice Address - Street 2:
Practice Address - City:IMPERIAL
Practice Address - State:CA
Practice Address - Zip Code:92251-9004
Practice Address - Country:US
Practice Address - Phone:760-540-0053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95027600363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily