# DERRICK LANE WILLIAMS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1922333194
- **Gender:** Man
- **Credential:** RN, APRN, ACNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 71003104A | IN | Yes |
| 363LA2100X | Acute Care Nurse Practitioner | 28139511A | IN | — |

## Other

- **Enumeration date:** 10/06/2009
- **Last updated:** 09/02/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200972030 | — | IN |