Provider Demographics
NPI:1497467393
Name:WILLIAMS, KIRA R (FNP-BC)
Entity Type:Individual
Prefix:
First Name:KIRA
Middle Name:R
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4602 67TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79414-5002
Mailing Address - Country:US
Mailing Address - Phone:806-993-7040
Mailing Address - Fax:
Practice Address - Street 1:4602 67TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79414-5002
Practice Address - Country:US
Practice Address - Phone:806-993-7040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-22
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1103042363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner