Provider Demographics
NPI:1578060042
Name:WILLIAMS, DENESE A (APRN)
Entity Type:Individual
Prefix:MRS
First Name:DENESE
Middle Name:A
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6856 AXIS WEST CIR
Mailing Address - Street 2:APT 3302
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32821-6109
Mailing Address - Country:US
Mailing Address - Phone:702-630-5620
Mailing Address - Fax:702-623-7635
Practice Address - Street 1:6856 AXIS WEST CIR
Practice Address - Street 2:APT 3302
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32821-6109
Practice Address - Country:US
Practice Address - Phone:702-630-5620
Practice Address - Fax:702-623-7635
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11010683363LP2300X
NVAPRN002861363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVAPRN002861OtherSTATE LICENSE
NV1578060042Medicaid