Individual
MS. MARY JEANNE WILLIAMS
Active
Individual
MS. MARY JEANNE WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
17838
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
083233
—
OR
05
—
NP3474
—
SC
01
—
SC69136067
MEDICARE PIN
SC
01
—
SC69136084
MEDICARE PIN
SC
Enumeration date
08/16/2006
Last updated
01/18/2021
Update your record
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