Provider Demographics
NPI:1679363949
Name:WILLIAMS, JESSICA ELAINE (NP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ELAINE
Last Name:WILLIAMS
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 E GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:MORTON
Mailing Address - State:TX
Mailing Address - Zip Code:79346-3444
Mailing Address - Country:US
Mailing Address - Phone:806-266-5566
Mailing Address - Fax:806-266-5342
Practice Address - Street 1:201 E GRANT AVE
Practice Address - Street 2:
Practice Address - City:MORTON
Practice Address - State:TX
Practice Address - Zip Code:79346-3444
Practice Address - Country:US
Practice Address - Phone:806-266-5566
Practice Address - Fax:806-266-5342
Is Sole Proprietor?:No
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX863477363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily