Provider Demographics
NPI:1902220494
Name:WILLIAMS, TANYA (APN)
Entity Type:Individual
Prefix:MS
First Name:TANYA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 WRIGHTS ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-6240
Mailing Address - Country:US
Mailing Address - Phone:501-321-9803
Mailing Address - Fax:501-321-0710
Practice Address - Street 1:115 WRIGHTS ST
Practice Address - Street 2:SUITE C
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6240
Practice Address - Country:US
Practice Address - Phone:501-321-9803
Practice Address - Fax:501-321-0710
Is Sole Proprietor?:No
Enumeration Date:2014-02-05
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004021363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily