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Individual

CAITLIN MAREE DEFAZIO WILLIAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
11145 HIGHWAY 6 W, THAXTON, MS 38871-9024
(662) 489-8500
Mailing address
128 CALLOWAY LOOP, PONTOTOC, MS 38863-6102
(662) 317-9783

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
903099
MS

Other

Enumeration date
01/08/2019
Last updated
04/15/2020
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