Provider Demographics
NPI:1497891253
Name:WILLIAMS, SYLVIA J (FNP)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:J
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:ND
Mailing Address - Zip Code:58401-6905
Mailing Address - Country:US
Mailing Address - Phone:701-253-3045
Mailing Address - Fax:701-253-3999
Practice Address - Street 1:2605 CIRCLE DR
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:ND
Practice Address - Zip Code:58401-6905
Practice Address - Country:US
Practice Address - Phone:701-253-3045
Practice Address - Fax:701-253-3999
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR25846363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDP20524Medicare UPIN