Doctor Name: | MRS. DEBORAH CARINA KELLY-WILLIAMS |
NPI Number: | 1093090284 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRNP |
License Number: | R144348 |
Business Practice Address: | 705 Digital Dr Ste G Linthicum Heights, MD - 210902267 |
Business Phone Number: | 4106363060 |
Business Fax Number: | 4106361675 |
Mailing Address: | 9524 Twilight Ct, COLUMBIA |
State: | MD |
Postal Code: | 210461954 |
Phone Number: | 3017259732 |
Fax Number: | 3017259732 |
NPI Enumeration Date: | 10/19/2011 |
NPI Last Update Date: | 10/19/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LG0600X |
License Number: | R144348 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Gerontology |
Taxonomy Definition: |