Provider Demographics
NPI:1740815307
Name:WILLIAMS, JANEEN NICOLE (FNP)
Entity type:Individual
Prefix:MS
First Name:JANEEN
Middle Name:NICOLE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:JANEEN
Other - Middle Name:NICOLE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:F341747-01
Mailing Address - Street 1:2 OSMUN PL
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-5238
Mailing Address - Country:US
Mailing Address - Phone:914-262-0982
Mailing Address - Fax:
Practice Address - Street 1:2 OSMUN PL
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-5238
Practice Address - Country:US
Practice Address - Phone:914-262-0982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-04
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF341747-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF341747-01Medicaid