Provider Demographics
NPI:1255396420
Name:WILLIAMS, PATRICIA W (NP)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:W
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 MEADE PARKWAY
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-4259
Mailing Address - Country:US
Mailing Address - Phone:757-539-0251
Mailing Address - Fax:757-934-2564
Practice Address - Street 1:2000 MEADE PARKWAY
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-4259
Practice Address - Country:US
Practice Address - Phone:757-539-0251
Practice Address - Fax:757-934-2564
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024047156363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00413964OtherRAILROAD MEDICARE
VA002494L76Medicare PIN
P96763Medicare UPIN