Provider Demographics
NPI:1386824530
Name:WILLIAMS, LORENA WHALAN (APRN-BC)
Entity Type:Individual
Prefix:
First Name:LORENA
Middle Name:WHALAN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:LORENA
Other - Middle Name:KATHLEEN
Other - Last Name:WHALAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:2311 M ST NW
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-1445
Mailing Address - Country:US
Mailing Address - Phone:202-466-3000
Mailing Address - Fax:202-466-3001
Practice Address - Street 1:2311 M ST NW
Practice Address - Street 2:SUITE 101
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1445
Practice Address - Country:US
Practice Address - Phone:202-466-3000
Practice Address - Fax:202-466-3001
Is Sole Proprietor?:No
Enumeration Date:2007-11-05
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1012653363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC208596YBCGMedicare UPIN