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Individual
DERRICK LANE WILLIAMS
Active
Individual
DERRICK LANE WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN, APRN, ACNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71003104A
IN
363LA2100X
Acute Care Nurse Practitioner
28139511A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200972030
—
IN
Enumeration date
10/06/2009
Last updated
09/02/2014
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