Provider Demographics
NPI:1740695550
Name:WILLIAMS, DIANA (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 1ST AVE NW STE 102
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-6169
Mailing Address - Country:US
Mailing Address - Phone:828-838-1225
Mailing Address - Fax:828-838-1225
Practice Address - Street 1:315 1ST AVE NW STE 102
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-6169
Practice Address - Country:US
Practice Address - Phone:828-838-1225
Practice Address - Fax:828-838-1225
Is Sole Proprietor?:No
Enumeration Date:2014-07-01
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC000000000363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0238GOtherBLUE CROSS BLUE SHIELD OF NC GROUP
NC890238GMedicaid
NC2335809Medicare PIN