Provider Demographics
NPI:1861435018
Name:WILLIAMS, KAREN Y (ARNP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:Y
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1042 FORT UNION BLVD # 473
Mailing Address - Street 2:
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047-1800
Mailing Address - Country:US
Mailing Address - Phone:603-548-0079
Mailing Address - Fax:
Practice Address - Street 1:50 N MEDICAL DR
Practice Address - Street 2:NEONATOLOGY SERVICES
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-0001
Practice Address - Country:US
Practice Address - Phone:801-581-2746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2011-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0432382310363LN0000X
UT7227185-4405363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH22565YOtherANTHEM REFERRING RAN
NH40Y002584NH02OtherANTHEM ACES
NHAA14483OtherHARVARD PILGRIM
NH6697615OtherCIGNA
NH30341532Medicaid
NH40Y002584NH02OtherANTHEM ACES
Q08990Medicare UPIN