Organization
LESLIE WILLIAMS APN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LESLIE ANN WILLIAMS APN (OWNER)
(618) 918-2115
Entity
Organization
Contact information
Practice address
1007 MARTIN LUTHER KING DR, CENTRALIA, IL 62801-3001
(618) 918-2115
(618) 918-2142
Mailing address
1998 STATE ROUTE 161, CENTRALIA, IL 62801-6754
(618) 339-2114
(918) 918-2142
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209007351
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209007351
—
IL
Enumeration date
04/16/2018
Last updated
03/22/2019
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