Provider Demographics
NPI:1437381670
Name:WILLIAMS, LA'ERICA L (APRN)
Entity Type:Individual
Prefix:
First Name:LA'ERICA
Middle Name:L
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 BARNES RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-1832
Mailing Address - Country:US
Mailing Address - Phone:203-626-5550
Mailing Address - Fax:203-626-5697
Practice Address - Street 1:85 BARNES RD
Practice Address - Street 2:SUITE 201
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-1832
Practice Address - Country:US
Practice Address - Phone:203-626-5550
Practice Address - Fax:203-626-5697
Is Sole Proprietor?:No
Enumeration Date:2009-08-21
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004214363LF0000X
CT4214363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004214OtherAPRN LICENSE