Provider Demographics
NPI:1881006344
Name:WILLIAMS, NICOLE P (CRNA)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:P
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:P
Other - Last Name:DANGALAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 4918
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32802-4918
Mailing Address - Country:US
Mailing Address - Phone:407-581-9180
Mailing Address - Fax:865-560-7066
Practice Address - Street 1:225 E ROBINSON ST
Practice Address - Street 2:SUITE #130
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-4322
Practice Address - Country:US
Practice Address - Phone:407-581-9180
Practice Address - Fax:865-560-7066
Is Sole Proprietor?:No
Enumeration Date:2014-06-02
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9298694367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered