Provider Demographics
NPI:1902321524
Name:WILLIAMS, VALARIE
Entity Type:Individual
Prefix:
First Name:VALARIE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8090 RIDGEMONT DR
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360-2664
Mailing Address - Country:US
Mailing Address - Phone:210-264-2552
Mailing Address - Fax:
Practice Address - Street 1:3600 JACKSON ST STE 219
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3040
Practice Address - Country:US
Practice Address - Phone:318-390-1796
Practice Address - Fax:888-235-4317
Is Sole Proprietor?:No
Enumeration Date:2017-08-04
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COC-APN.0002712-C-NP363LP0808X
TXAP136092363LF0000X, 363LP0808X
LA218964363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily