Provider Demographics
NPI:1679073407
Name:MCWILLIAMS, MICAH MICHELLE (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:MS
First Name:MICAH
Middle Name:MICHELLE
Last Name:MCWILLIAMS
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6108 SUE ANNE
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-6349
Mailing Address - Country:US
Mailing Address - Phone:254-449-1221
Mailing Address - Fax:
Practice Address - Street 1:36065 SANTA FE AVE
Practice Address - Street 2:
Practice Address - City:FORT HOOD
Practice Address - State:TX
Practice Address - Zip Code:76544-5060
Practice Address - Country:US
Practice Address - Phone:254-553-5900
Practice Address - Fax:254-287-7690
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-19
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP136403363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily