Provider Demographics
NPI:1861084881
Name:WILLIAMS, NADINE N (A-GNP-C, PMHNP-C)
Entity type:Individual
Prefix:
First Name:NADINE
Middle Name:N
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:A-GNP-C, PMHNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7544 SOUTHLAKE PKWY STE 102B
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-2495
Mailing Address - Country:US
Mailing Address - Phone:770-240-4849
Mailing Address - Fax:
Practice Address - Street 1:7544 SOUTHLAKE PKWY STE 102B
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-2495
Practice Address - Country:US
Practice Address - Phone:770-240-4849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-10
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN188664363LP0808X, 363LP2300X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care