Provider Demographics
NPI:1417001850
Name:WILLIAMS, LINDA E (NP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:E
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 432
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41502-0432
Mailing Address - Country:US
Mailing Address - Phone:606-218-3500
Mailing Address - Fax:
Practice Address - Street 1:172 S MAYO TRL
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-1515
Practice Address - Country:US
Practice Address - Phone:606-218-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3002675363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP00104432OtherRAILROAD MEDICARE PROV #
KY000000315142OtherBCBS PROVIDER NUMBER
KY78267507Medicaid
KY3396775Medicare PIN
KY000000315142OtherBCBS PROVIDER NUMBER