Provider Demographics
NPI:1407115579
Name:WILLIAMS, ALLYSON BROOKE (APN)
Entity Type:Individual
Prefix:
First Name:ALLYSON
Middle Name:BROOKE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5050 POPLAR AVENUE SUITE 511
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38157-0618
Mailing Address - Country:US
Mailing Address - Phone:901-682-3035
Mailing Address - Fax:
Practice Address - Street 1:5050 POPLAR AVENUE SUITE 511
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38157-0618
Practice Address - Country:US
Practice Address - Phone:901-682-3035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-10
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16644363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health