Provider Demographics
NPI:1861084881
Name:WILLIAMS, NADINE N (A-GNP-C)
Entity type:Individual
Prefix:
First Name:NADINE
Middle Name:N
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:A-GNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:267 LANGLEY DR # 1285
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-6907
Mailing Address - Country:US
Mailing Address - Phone:678-599-3670
Mailing Address - Fax:
Practice Address - Street 1:267 LANGLEY DR # 1285
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-6907
Practice Address - Country:US
Practice Address - Phone:678-599-3670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-10
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN188664363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty