Provider Demographics
NPI:1952727000
Name:WILLIAMS, JULIE KAY (ANP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:KAY
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:365 SHOSHONI
Mailing Address - Street 2:
Mailing Address - City:SILT
Mailing Address - State:CO
Mailing Address - Zip Code:81652-9581
Mailing Address - Country:US
Mailing Address - Phone:501-545-0274
Mailing Address - Fax:
Practice Address - Street 1:630 RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:RIFLE
Practice Address - State:CO
Practice Address - Zip Code:81650-3550
Practice Address - Country:US
Practice Address - Phone:501-545-0274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-13
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004028363LP2300X
COAPN.0995043-NP207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR202833758Medicaid
ARA004028OtherLICENSE (CNP)
AR202833758Medicaid