Provider Demographics
NPI:1457438400
Name:WILLIAMS, STEPHANIE A (DNP, APRN, ACNP-BC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:A
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DNP, APRN, ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16605 SOUTHWEST FREEWAY
Mailing Address - Street 2:MOB 3, SUITE 220
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479
Mailing Address - Country:US
Mailing Address - Phone:281-494-3000
Mailing Address - Fax:
Practice Address - Street 1:16605 SOUTHWEST FREEWAY
Practice Address - Street 2:MOB 3, SUITE 220
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479
Practice Address - Country:US
Practice Address - Phone:281-494-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT233732163WX0200X, 363L00000X, 363LA2100X
TX673891363LA2100X
TXAP110739363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WX0200XNursing Service ProvidersRegistered NurseOncology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX156857802Medicaid
TX8N3678OtherBCBS
TX156857802Medicaid
P80868Medicare UPIN