Provider Demographics
NPI:1558812842
Name:WILLIAMS, JASON L (APRN)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:L
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 CHILDRENS WAY # 653
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-3500
Mailing Address - Country:US
Mailing Address - Phone:501-364-1100
Mailing Address - Fax:501-364-4082
Practice Address - Street 1:1210 WOLFE ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-4618
Practice Address - Country:US
Practice Address - Phone:501-364-5150
Practice Address - Fax:501-364-3966
Is Sole Proprietor?:No
Enumeration Date:2016-10-20
Last Update Date:2022-09-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARA004936363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily