Provider Demographics
NPI:1689159766
Name:WILLIAMS, IVORY (DNP, APRN, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:IVORY
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DNP, 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 1:203 SALISBURY ST
Mailing Address - Street 2:
Mailing Address - City:WADESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28170-2155
Mailing Address - Country:US
Mailing Address - Phone:704-694-6700
Mailing Address - Fax:704-695-1227
Practice Address - Street 1:203 SALISBURY ST
Practice Address - Street 2:
Practice Address - City:WADESBORO
Practice Address - State:NC
Practice Address - Zip Code:28170-2155
Practice Address - Country:US
Practice Address - Phone:704-694-6700
Practice Address - Fax:704-695-1227
Is Sole Proprietor?:No
Enumeration Date:2018-09-25
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22318363LF0000X
NC5012522363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily