Provider Demographics
NPI:1437779436
Name:WILLIAMS, MORGAN NELMS
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:NELMS
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 DUTCHMAN RD
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30223-6667
Mailing Address - Country:US
Mailing Address - Phone:678-967-1961
Mailing Address - Fax:
Practice Address - Street 1:874 LANIER AVE W STE 220
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-7659
Practice Address - Country:US
Practice Address - Phone:678-833-1444
Practice Address - Fax:678-833-1445
Is Sole Proprietor?:No
Enumeration Date:2020-04-20
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN265308163W00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse