Provider Demographics
NPI:1689205577
Name:WILLIAMS, KAMIE S (AGNP-C)
Entity Type:Individual
Prefix:
First Name:KAMIE
Middle Name:S
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 LAKEVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-7512
Mailing Address - Country:US
Mailing Address - Phone:985-875-1020
Mailing Address - Fax:985-875-1205
Practice Address - Street 1:120 LAKEVIEW CIR
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-7512
Practice Address - Country:US
Practice Address - Phone:985-875-1020
Practice Address - Fax:985-875-1205
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-29
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA210982363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner