Individual
MRS. MICOLE WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
208 BALLIS LN, SHREVEPORT, LA 71106-7988
(318) 393-2790
Mailing address
208 BALLIS LN, SHREVEPORT, LA 71106-7988
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP007766
LA
Other
Enumeration date
06/05/2014
Last updated
07/20/2023
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