Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | PENDING | CA |
N | 363LG0600X | Nurse Practitioner - Gerontology | PENDING | CA |
NPI | 1639821655 |
---|---|
Provider Name | Katelyn L Williams |
First Address | Fresno, CA 93721-1431 |
Second Address | Fresno, CA 93721-1324 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2022 |
Last Update Date | 01/02/2022 |