Provider Demographics
NPI:1679991624
Name:WILLIAMS, DENIESE (ARNP)
Entity Type:Individual
Prefix:
First Name:DENIESE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:DENIESE
Other - Middle Name:
Other - Last Name:WOODBURN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7333 SCOTLAND WAY OFC
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34238-8556
Mailing Address - Country:US
Mailing Address - Phone:941-552-5355
Mailing Address - Fax:941-552-5309
Practice Address - Street 1:7333 SCOTLAND WAY OFC
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34238-8556
Practice Address - Country:US
Practice Address - Phone:941-552-5355
Practice Address - Fax:941-552-5309
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-06
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 2886402363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology