Provider Demographics
NPI:1346438017
Name:WILLIAMS, REBECCA L (RN, APRN, FNP)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:L
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN, APRN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1914 SWIFT AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3447
Mailing Address - Country:US
Mailing Address - Phone:816-221-1603
Mailing Address - Fax:816-472-6266
Practice Address - Street 1:1914 SWIFT AVE
Practice Address - Street 2:
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3447
Practice Address - Country:US
Practice Address - Phone:816-221-1603
Practice Address - Fax:816-472-6266
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002014651363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOX93000048Medicare PIN