Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LG0600X | Nurse Practitioner - Gerontology | 0024182772 | VA |
Y | 363LP2300X | Nurse Practitioner - Primary Care | 5013364 | NC |
NPI | 1083223879 |
---|---|
Provider Name | Stanisha Natrice Williams |
First Address | Greenville, NC 27858-8470 |
Second Address | Durham, NC 27713-1869 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2020 |
Last Update Date | 10/11/2021 |