Provider Demographics
NPI:1104245604
Name:WILLIAMS, ASHLEY (RN, MSN, A-GNP-C)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN, MSN, A-GNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9625 GRALLATORIAL CIR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32507-7204
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:236 W GARDEN ST STE 4
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32502-5757
Practice Address - Country:US
Practice Address - Phone:850-469-0020
Practice Address - Fax:850-469-0097
Is Sole Proprietor?:No
Enumeration Date:2014-04-11
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-117974363L00000X
FL9380243363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner