Provider Demographics
NPI:1578850822
Name:WILLIAMS, EVELYN CASEY (MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:CASEY
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 E NORTH ST STE 5
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-2437
Mailing Address - Country:US
Mailing Address - Phone:864-292-2266
Mailing Address - Fax:864-292-8356
Practice Address - Street 1:4200 E NORTH ST STE 5
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-2437
Practice Address - Country:US
Practice Address - Phone:864-292-2266
Practice Address - Fax:864-292-8356
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4485363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily