Provider Demographics
NPI:1538825443
Name:WILLIAMS, BRITTEN WAYNE (APRN)
Entity type:Individual
Prefix:
First Name:BRITTEN
Middle Name:WAYNE
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 GREENE 712 RD
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-8275
Mailing Address - Country:US
Mailing Address - Phone:870-565-8190
Mailing Address - Fax:
Practice Address - Street 1:303 E MATTHEWS AVE STE 100
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-3113
Practice Address - Country:US
Practice Address - Phone:870-207-2926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-15
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR214690363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily