Provider Demographics
NPI:1225227093
Name:WILLIAMS, CAREY (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:CAREY
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 LIGHTWOOD RD STE 1
Mailing Address - Street 2:
Mailing Address - City:DEATSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36022-3800
Mailing Address - Country:US
Mailing Address - Phone:334-543-4164
Mailing Address - Fax:334-543-4165
Practice Address - Street 1:213 LIGHTWOOD RD STE 1
Practice Address - Street 2:
Practice Address - City:DEATSVILLE
Practice Address - State:AL
Practice Address - Zip Code:36022-3800
Practice Address - Country:US
Practice Address - Phone:334-543-4164
Practice Address - Fax:334-543-4165
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-099602363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily