Provider Demographics
NPI:1356539613
Name:WILLIAMS, KELLY LYNNE (RN)
Entity type:Individual
Prefix:MISS
First Name:KELLY
Middle Name:LYNNE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 827
Mailing Address - Street 2:BOX 82
Mailing Address - City:NAPLES
Mailing Address - State:FPO AE
Mailing Address - Zip Code:09671
Mailing Address - Country:IT
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PSC 827
Practice Address - Street 2:BOX 1000
Practice Address - City:NAPLES
Practice Address - State:FPO AE
Practice Address - Zip Code:09671
Practice Address - Country:IT
Practice Address - Phone:081-811-6472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN553435163WX0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient