Provider Demographics
NPI:1164912234
Name:WILLIAMS, BRIDGET SHAWNTAY (NP-C)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:SHAWNTAY
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:BRIDGET
Other - Middle Name:SHAWNTAY
Other - Last Name:SKINNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:1311 W PRESIDENT GEORGE BUSH HWY
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-1153
Mailing Address - Country:US
Mailing Address - Phone:254-749-4314
Mailing Address - Fax:
Practice Address - Street 1:1311 W PRESIDENT GEORGE BUSH HWY
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-1153
Practice Address - Country:US
Practice Address - Phone:254-749-4314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-15
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137004363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily