Provider Demographics
NPI:1891409330
Name:WILLIAMS, LEAH KIMBERLY (NP)
Entity Type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:KIMBERLY
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 ENNIS ST
Mailing Address - Street 2:
Mailing Address - City:SARALAND
Mailing Address - State:AL
Mailing Address - Zip Code:36571-2706
Mailing Address - Country:US
Mailing Address - Phone:251-544-2000
Mailing Address - Fax:251-544-2004
Practice Address - Street 1:119 ENNIS ST
Practice Address - Street 2:
Practice Address - City:SARALAND
Practice Address - State:AL
Practice Address - Zip Code:36571-2706
Practice Address - Country:US
Practice Address - Phone:251-544-2000
Practice Address - Fax:251-544-2004
Is Sole Proprietor?:No
Enumeration Date:2023-01-10
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
AL1-128859363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program