Individual
MIRENDA LATISA WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
2365 SPRINGS RD NE, HICKORY, NC 28601-3067
(828) 325-0950
(828) 325-0248
Mailing address
4419 KARLBROOK LN, RALEIGH, NC 27616-6199
(919) 491-9226
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
5007484
NC
363LG0600X
Gerontology Nurse Practitioner
5007484
NC
Other
Enumeration date
03/09/2015
Last updated
03/09/2015
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