Provider Demographics
NPI:1609379403
Name:WILLIAMS, BETTY MICHELLE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:BETTY
Middle Name:MICHELLE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6800 HERITAGE PKWY STE 201
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-8746
Mailing Address - Country:US
Mailing Address - Phone:972-412-8700
Mailing Address - Fax:
Practice Address - Street 1:6800 HERITAGE PKWY STE 201
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-8746
Practice Address - Country:US
Practice Address - Phone:972-412-8700
Practice Address - Fax:972-412-9700
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-18
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP136426363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily