Provider Demographics
NPI:1578344628
Name:WILLIAMS, RACHEAL (FNP-C)
Entity Type:Individual
Prefix:
First Name:RACHEAL
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-1812
Mailing Address - Country:US
Mailing Address - Phone:928-246-5582
Mailing Address - Fax:
Practice Address - Street 1:1950 W 3RD ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-1812
Practice Address - Country:US
Practice Address - Phone:928-276-4477
Practice Address - Fax:928-276-4481
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-12
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ162512163W00000X
AZ303576363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse