Provider Demographics
NPI:1720026578
Name:WILLIAMS, MAXINE ELIZABETH (APRN - FNP)
Entity Type:Individual
Prefix:MS
First Name:MAXINE
Middle Name:ELIZABETH
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:APRN - FNP
Other - Prefix:MRS
Other - First Name:MAXINE
Other - Middle Name:
Other - Last Name:MORALES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN - FNP
Mailing Address - Street 1:110 CLYDE DR
Mailing Address - Street 2:
Mailing Address - City:WALHALLA
Mailing Address - State:SC
Mailing Address - Zip Code:29691-4006
Mailing Address - Country:US
Mailing Address - Phone:864-898-5823
Mailing Address - Fax:864-898-5568
Practice Address - Street 1:200 MCDANIEL AVE
Practice Address - Street 2:
Practice Address - City:PICKENS
Practice Address - State:SC
Practice Address - Zip Code:29671-2527
Practice Address - Country:US
Practice Address - Phone:864-898-5823
Practice Address - Fax:864-898-5568
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1333363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily