Provider Demographics
NPI:1518056050
Name:WILLIAMS, SERENA R (ARNP, MSN, FNP)
Entity Type:Individual
Prefix:
First Name:SERENA
Middle Name:R
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:ARNP, MSN, FNP
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Mailing Address - Street 1:3900 S ZINTEL WAY
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99337-5092
Mailing Address - Country:US
Mailing Address - Phone:509-942-3627
Mailing Address - Fax:509-942-2268
Practice Address - Street 1:1135 JADWIN AVE
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-3434
Practice Address - Country:US
Practice Address - Phone:509-942-3300
Practice Address - Fax:509-946-1868
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2021-11-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAAP30006955363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1518056050Medicaid
WA0305814OtherL&I NUMBER
WA1518056050Medicaid