Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 5006701 | NC |
NPI | 1023301124 |
---|---|
Provider Name | Mrs. Thalia N Williams |
First Address | Rocky Mount, NC 27802-2723 |
Second Address | Rocky Mount, NC 27804-3017 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2011 |
Last Update Date | 28/10/2020 |