Individual
MS. MARY JEANNE WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
2995 REIDVILLE RD STE 100, SPARTANBURG, SC 29301-5600
(864) 587-3000
(864) 587-3019
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
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
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