Provider Demographics
NPI:1902144637
Name:WILLIAMS, WHITNEY NICOLE (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:NICOLE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:5040 BILL GARDNER PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LOCUST GROVE
Mailing Address - State:GA
Mailing Address - Zip Code:30248-3645
Mailing Address - Country:US
Mailing Address - Phone:678-583-5437
Mailing Address - Fax:678-583-5484
Practice Address - Street 1:5040 BILL GARDNER PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:LOCUST GROVE
Practice Address - State:GA
Practice Address - Zip Code:30248-3645
Practice Address - Country:US
Practice Address - Phone:678-583-5437
Practice Address - Fax:678-583-5484
Is Sole Proprietor?:No
Enumeration Date:2013-01-31
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN205403363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner