Provider Demographics
NPI:1558473033
Name:WILLIAMS, SHIRLEY JEAN (PNP)
Entity Type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:JEAN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3520 5TH ST
Mailing Address - Street 2:
Mailing Address - City:EAST MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61244
Mailing Address - Country:US
Mailing Address - Phone:309-281-2420
Mailing Address - Fax:309-281-2429
Practice Address - Street 1:1314 10TH ST
Practice Address - Street 2:SCHOOL HEALTH LINK
Practice Address - City:SILVIS
Practice Address - State:IL
Practice Address - Zip Code:61282-1892
Practice Address - Country:US
Practice Address - Phone:309-281-2420
Practice Address - Fax:309-281-2429
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209001048363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner