Individual
JAMIE MICHELLE WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3805 W 28TH AVE, PINE BLUFF, AR 71603-4774
(870) 536-4100
Mailing address
3805 W 28TH AVE, PINE BLUFF, AR 71603-4774
(870) 536-4100
(870) 534-3982
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
C02762
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1518194828
TRICARE / CHAMPUS
—
01
—
5R489
BCBS
AR
01
—
P00726875
PGBA RR MEDICQRE
—
Enumeration date
06/12/2009
Last updated
04/28/2020
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