Provider Demographics
NPI:1386191773
Name:WILLIAMS, LACRESHA F (NP)
Entity Type:Individual
Prefix:
First Name:LACRESHA
Middle Name:F
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1510
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47706-1510
Mailing Address - Country:US
Mailing Address - Phone:812-450-6815
Mailing Address - Fax:812-421-2883
Practice Address - Street 1:4506 1ST AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47710-3624
Practice Address - Country:US
Practice Address - Phone:812-428-6161
Practice Address - Fax:812-421-2883
Is Sole Proprietor?:No
Enumeration Date:2016-09-02
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN71006673A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner