Provider Demographics
NPI:1205809563
Name:WILLIAMS, NANCY JEAN (WHNP)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:JEAN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 PARK PLACE DR
Mailing Address - Street 2:APT 1405
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433
Mailing Address - Country:US
Mailing Address - Phone:865-765-5396
Mailing Address - Fax:
Practice Address - Street 1:110 LAKEVIEW DR
Practice Address - Street 2:SUITE 100
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-7511
Practice Address - Country:US
Practice Address - Phone:985-898-1940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12388363LW0102X
LAAP06294363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health