Provider Demographics
NPI:1750669016
Name:WILLIAMS, LORELEI (NP)
Entity type:Individual
Prefix:
First Name:LORELEI
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:2690 S CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-3002
Mailing Address - Country:US
Mailing Address - Phone:269-428-2800
Mailing Address - Fax:269-428-7177
Practice Address - Street 1:2690 S CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-3002
Practice Address - Country:US
Practice Address - Phone:269-428-2800
Practice Address - Fax:269-428-7177
Is Sole Proprietor?:No
Enumeration Date:2011-08-03
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN28177752A363LX0001X
MI4704422241363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology