Individual
MRS. MARY SMITH WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1253 PARIS RD, MAYFIELD, KY 42066-4989
(270) 247-2455
Mailing address
433 E PARKVIEW ST, DYERSBURG, TN 38024-3111
(731) 287-7289
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95546
TN
163WG0000X
General Practice Registered Nurse
A167618
IA
363LF0000X
Family Nurse Practitioner
Primary
17932
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1356573463
SOLE PROPRIETOR
TN
Enumeration date
08/23/2009
Last updated
05/13/2022
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