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Individual
MRS. KELLIE SUE WILLIAMS
Active
Individual
MRS. KELLIE SUE WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
APRN11012874
FL
363L00000X
Nurse Practitioner
RN094494NP
GA
363LF0000X
Family Nurse Practitioner
Primary
APRN11012874
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110883800
—
FL
05
—
1992006506
—
GA
01
—
XJYGA
BLUE SHIELD
FL
Enumeration date
11/12/2010
Last updated
01/23/2023
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