Provider Demographics
NPI:1255039806
Name:WILLIAMS, KATARINA (CPNP-PC, BSN, RN)
Entity type:Individual
Prefix:
First Name:KATARINA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CPNP-PC, BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 N TERRACE AVE SE
Mailing Address - Street 2:
Mailing Address - City:LINDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30147-1123
Mailing Address - Country:US
Mailing Address - Phone:540-846-9821
Mailing Address - Fax:
Practice Address - Street 1:140 THREE RIVERS DR NE
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30161-4999
Practice Address - Country:US
Practice Address - Phone:706-232-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN306261208000000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No208000000XAllopathic & Osteopathic PhysiciansPediatrics