Provider Demographics
NPI:1619633062
Name:WILLIAMS, AMBER LYNN (MSN APRN FNP-BC)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:LYNN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MSN APRN FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 S MCGEE RD
Mailing Address - Street 2:
Mailing Address - City:BONIFAY
Mailing Address - State:FL
Mailing Address - Zip Code:32425-3101
Mailing Address - Country:US
Mailing Address - Phone:606-670-0554
Mailing Address - Fax:
Practice Address - Street 1:340 W 23RD ST STE K
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-4541
Practice Address - Country:US
Practice Address - Phone:850-747-8787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-10
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11015238363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily