Individual
FANNIE LAURA WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8300 HOUGH AVE, CLEVELAND, OH 44103-4247
(216) 231-7700
(216) 231-7920
Mailing address
8300 HOUGH AVE, CLEVELAND, OH 44103-4247
(216) 231-7700
(216) 231-7920
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
COA.12676-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0055717
—
OH
Enumeration date
10/19/2011
Last updated
11/21/2015
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