Doctor Name: | JUANA MARIA AMBRIZ DE WILLIAMS |
NPI Number: | 1083081129 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DNP, FNP-BC |
License Number: | 28171474A |
Business Practice Address: | 14121 Parke Long Ct Suite 201 Chantilly, VA - 201511647 |
Business Phone Number: | 7032606530 |
Business Fax Number: | 8007522471 |
Mailing Address: | 951 Transport Dr, VALPARAISO |
State: | IN |
Postal Code: | 463838434 |
Phone Number: | 2194627173 |
Fax Number: | 2194659502 |
NPI Enumeration Date: | 08/24/2015 |
NPI Last Update Date: | 10/15/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 28171474A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |