Provider Demographics
NPI:1174645113
Name:WILLIAMS, JOANNE MARLENE (CNP)
Entity Type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:MARLENE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8712 CHAMBERS PL NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-2138
Mailing Address - Country:US
Mailing Address - Phone:505-797-1944
Mailing Address - Fax:505-821-2280
Practice Address - Street 1:8712 CHAMBERS PL NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-2138
Practice Address - Country:US
Practice Address - Phone:505-797-1944
Practice Address - Fax:505-821-2280
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR19039363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health