Doctor Name: | EARNESTINE WILLIAMS |
NPI Number: | 1609251560 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 1-058459 |
Business Practice Address: | 13833 Tapia Ave Bayou La Batre, AL - 365092515 |
Business Phone Number: | 2518244985 |
Business Fax Number: | 2518244990 |
Mailing Address: | 13833 Tapia Ave, BAYOU LA BATRE |
State: | AL |
Postal Code: | 365092515 |
Phone Number: | 2518244985 |
Fax Number: | 2518244990 |
NPI Enumeration Date: | 07/21/2015 |
NPI Last Update Date: | 10/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 1-058459 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |