Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | AO1434 | AR |
NPI | 1073735205 |
---|---|
Provider Name | Ms. Lori K Williams |
First Address | Little Rock, AR 72211-3896 |
Second Address | Little Rock, AR 72211-3896 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
OTH001 | (02) | AR |