Provider Demographics
NPI:1801842778
Name:WILLIAMS, JOAN E (RN,CNP)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:E
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN,CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5620 CLAIRE CT
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-2440
Mailing Address - Country:US
Mailing Address - Phone:614-793-1497
Mailing Address - Fax:
Practice Address - Street 1:757 BROOKSEDGE PLAZA DR
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-4913
Practice Address - Country:US
Practice Address - Phone:614-818-6156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-00701363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHWINP03456Medicare ID - Type Unspecified