Provider Demographics
NPI:1356888671
Name:WILLIAMS, DEANNE LEIGH (FNP)
Entity type:Individual
Prefix:
First Name:DEANNE
Middle Name:LEIGH
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 100174
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29202-3174
Mailing Address - Country:US
Mailing Address - Phone:864-512-5667
Mailing Address - Fax:864-512-6746
Practice Address - Street 1:2000 E GREENVILLE ST STE 1100
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1714
Practice Address - Country:US
Practice Address - Phone:864-512-5667
Practice Address - Fax:864-512-6746
Is Sole Proprietor?:No
Enumeration Date:2017-01-24
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20382363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner