Provider Demographics
NPI:1912459678
Name:WILLIAMS, KESHA GODFREY (FNP)
Entity Type:Individual
Prefix:
First Name:KESHA
Middle Name:GODFREY
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:VANKESHA
Other - Middle Name:EWAE
Other - Last Name:GODFREY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-C
Mailing Address - Street 1:4600 GULF FWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77023-3548
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9919 NORTH FWY STE 107
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77037-1272
Practice Address - Country:US
Practice Address - Phone:713-514-1107
Practice Address - Fax:404-494-7435
Is Sole Proprietor?:No
Enumeration Date:2016-10-28
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX801240163W00000X
TXAP131839363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse