Provider Demographics
NPI:1336142611
Name:WILLIAMS, PAULA A (CNM)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:A
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:
Other - Last Name:MORELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:4685 FOREST AVE
Mailing Address - Street 2:STE C
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-3359
Mailing Address - Country:US
Mailing Address - Phone:513-751-5900
Mailing Address - Fax:
Practice Address - Street 1:3440 BURNET AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-2843
Practice Address - Country:US
Practice Address - Phone:513-751-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2017-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN280494163W00000X
KY3006701363L00000X
OHNM0600367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2267587Medicaid
KY78016250Medicaid
OHP41123Medicare UPIN
OH2267587Medicaid
KYP400032791Medicare PIN
OHMONM02301Medicare ID - Type Unspecified