Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 11003090 | FL |
NPI | 1033763156 |
---|---|
Provider Name | Teresa Anne Williams |
First Address | Pensacola, FL 32501-6335 |
Second Address | Tripler Army Medical Center, HI 96859-5001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2019 |
Last Update Date | 15/01/2021 |