| Doctor Name: | TINA DENISE WILLIAMS |
| NPI Number: | 1154659100 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 151209 |
| Business Practice Address: | 5480 Goodman Rd Olive Branch, MS - 386547902 |
| Business Phone Number: | 6628939300 |
| Business Fax Number: | |
| Mailing Address: | 1265 Union Ave Ste 545, MEMPHIS |
| State: | TN |
| Postal Code: | 381043415 |
| Phone Number: | 9015167010 |
| Fax Number: | 9015168433 |
| NPI Enumeration Date: | 12/03/2009 |
| NPI Last Update Date: | 04/15/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 151209 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |