Provider Demographics
NPI:1811563489
Name:WILLIAMS, CARRIE LYNN (APRN, A-GNP-C)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:LYNN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:APRN, A-GNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 39TH CT
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32968-1959
Mailing Address - Country:US
Mailing Address - Phone:772-633-0821
Mailing Address - Fax:
Practice Address - Street 1:3450 11TH CT STE 105
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-5012
Practice Address - Country:US
Practice Address - Phone:772-563-4580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-03
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11013445363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty