Provider Demographics
NPI:1417301615
Name:WILLIAMS, ALLYSON MARIE (NP)
Entity Type:Individual
Prefix:MRS
First Name:ALLYSON
Middle Name:MARIE
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 1:19550 E 39TH ST S
Mailing Address - Street 2:STE 410
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64057-2358
Mailing Address - Country:US
Mailing Address - Phone:816-303-2400
Mailing Address - Fax:816-303-2484
Practice Address - Street 1:19550 E 39TH ST S
Practice Address - Street 2:STE 410
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-2358
Practice Address - Country:US
Practice Address - Phone:816-303-2400
Practice Address - Fax:816-303-2484
Is Sole Proprietor?:No
Enumeration Date:2016-04-14
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016003718363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner