Provider Demographics
NPI:1295769164
Name:WILLIAMS, LINDA LORRAINE (APRN)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:LORRAINE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 W GREENWOOD ST SUITE 5
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29620-5717
Mailing Address - Country:US
Mailing Address - Phone:864-366-9938
Mailing Address - Fax:864-366-0818
Practice Address - Street 1:901 W GREENWOOD ST SUITE 5
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:SC
Practice Address - Zip Code:29620-5717
Practice Address - Country:US
Practice Address - Phone:864-366-9938
Practice Address - Fax:864-366-0818
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC528363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily