Provider Demographics
NPI:1992006399
Name:WILLIAMS, LEANN ELIZABETH (FNP-BC)
Entity Type:Individual
Prefix:
First Name:LEANN
Middle Name:ELIZABETH
Last Name:WILLIAMS
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 1:600 W MORRISON ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTE
Mailing Address - State:MO
Mailing Address - Zip Code:65248-1471
Mailing Address - Country:US
Mailing Address - Phone:660-248-2900
Mailing Address - Fax:660-831-3372
Practice Address - Street 1:600 W MORRISON ST
Practice Address - Street 2:SUITE 5
Practice Address - City:FAYETTE
Practice Address - State:MO
Practice Address - Zip Code:65248-1075
Practice Address - Country:US
Practice Address - Phone:660-248-2900
Practice Address - Fax:660-831-3372
Is Sole Proprietor?:No
Enumeration Date:2010-11-16
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010012057363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily