Individual
DESIREE DIAN WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
12750 SAINT FRANCIS DR STE 410, CROWN POINT, IN 46307-0264
(219) 769-8340
(219) 769-8341
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
28130302A
IN
363LF0000X
Family Nurse Practitioner
2013001517
IN
363LF0000X
Family Nurse Practitioner
Primary
71004561A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201267680
—
IN
01
—
736980001
MEDICARE
IN
Enumeration date
03/19/2013
Last updated
02/10/2025
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