Provider Demographics
NPI:1952036618
Name:MCWILLIAMS, MAYTE (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:MAYTE
Middle Name:
Last Name:MCWILLIAMS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 LINTON BELLEVUE RD
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:LA
Mailing Address - Zip Code:71006-4428
Mailing Address - Country:US
Mailing Address - Phone:318-212-7793
Mailing Address - Fax:
Practice Address - Street 1:2300 HOSPITAL DR STE 300
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-2157
Practice Address - Country:US
Practice Address - Phone:318-212-7793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN142061163W00000X
LA226816363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse