Provider Demographics
NPI:1245325711
Name:WILLIAMS, KATHY YVONNE (CPM-TN)
Entity type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:YVONNE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CPM-TN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6010 LAKEVIEW RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:TN
Mailing Address - Zip Code:37172-6620
Mailing Address - Country:US
Mailing Address - Phone:615-838-8300
Mailing Address - Fax:615-384-1457
Practice Address - Street 1:6010 LAKEVIEW RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:TN
Practice Address - Zip Code:37172-6620
Practice Address - Country:US
Practice Address - Phone:615-838-8300
Practice Address - Fax:615-384-1457
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNEMT000031310146N00000X
TNCPM000000020176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic