Provider Demographics
NPI:1629295761
Name:WILLIAMS, KAREN DELANE (APN)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:DELANE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:5 SAINT VINCENT CIR
Mailing Address - Street 2:STE 501
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5412
Mailing Address - Country:US
Mailing Address - Phone:501-666-2894
Mailing Address - Fax:501-666-9017
Practice Address - Street 1:#5 ST VINCENT CIRCLE
Practice Address - Street 2:STE 501
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205
Practice Address - Country:US
Practice Address - Phone:501-666-2894
Practice Address - Fax:501-566-6901
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA01884363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARQ47595Medicare UPIN
AR5Y426Medicare ID - Type Unspecified