Provider Demographics
NPI:1629423306
Name:WILLIAMS, WHITNEY SHAW (NP)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:SHAW
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:SHAW
Other - Last Name:TERRILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:WHNP
Mailing Address - Street 1:784 HERCULES DR
Mailing Address - Street 2:STE 110
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-8049
Mailing Address - Country:US
Mailing Address - Phone:802-448-9755
Mailing Address - Fax:
Practice Address - Street 1:443 CONGRESS ST FL 2
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-3531
Practice Address - Country:US
Practice Address - Phone:207-797-8881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-29
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95004254363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health