Individual
SERENA R WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP, MSN, FNP
Contact information
Practice address
1135 JADWIN AVE, RICHLAND, WA 99352-3434
(509) 942-3300
(509) 946-1868
Mailing address
3900 S ZINTEL WAY, KENNEWICK, WA 99337-5092
(509) 942-3627
(509) 942-2268
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP30006955
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0305814
L&I NUMBER
WA
05
—
1518056050
—
WA
Enumeration date
10/12/2006
Last updated
11/11/2021
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