Provider Demographics
NPI:1265999098
Name:WILLIAMS, DESIREE N (CRNP)
Entity type:Individual
Prefix:MRS
First Name:DESIREE
Middle Name:N
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:389 DURBIN ST
Mailing Address - Street 2:
Mailing Address - City:RAMEY
Mailing Address - State:PA
Mailing Address - Zip Code:16671-1023
Mailing Address - Country:US
Mailing Address - Phone:814-238-1066
Mailing Address - Fax:
Practice Address - Street 1:389 DURBIN ST
Practice Address - Street 2:
Practice Address - City:RAMEY
Practice Address - State:PA
Practice Address - Zip Code:16671-1667
Practice Address - Country:US
Practice Address - Phone:814-592-5880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-28
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP020057163WP2201X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care