Provider Demographics
NPI:1487030474
Name:WILLIAMS, FELISSA PATTERSON (APRN)
Entity type:Individual
Prefix:
First Name:FELISSA
Middle Name:PATTERSON
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 BRECKENRIDGE LN STE 147
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40218-4175
Mailing Address - Country:US
Mailing Address - Phone:502-708-1904
Mailing Address - Fax:
Practice Address - Street 1:4400 BRECKENRIDGE LN STE 147
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-4175
Practice Address - Country:US
Practice Address - Phone:502-708-1904
Practice Address - Fax:502-708-2547
Is Sole Proprietor?:No
Enumeration Date:2015-08-03
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3009146363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily