Provider Demographics
NPI:1740807585
Name:WILLIAMS, TERENCE CHRISTOPHER (FNP-BC)
Entity type:Individual
Prefix:MR
First Name:TERENCE
Middle Name:CHRISTOPHER
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:MR
Other - First Name:TERENCE
Other - Middle Name:CHRISTOPHER
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-316-3612
Mailing Address - Fax:704-316-3613
Practice Address - Street 1:9550 ROCKY RIVER RD # 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-9592
Practice Address - Country:US
Practice Address - Phone:704-316-3612
Practice Address - Fax:704-316-3613
Is Sole Proprietor?:No
Enumeration Date:2020-06-27
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC221669163WE0003X, 363LF0000X
NC5013291363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily