Provider Demographics
NPI:1063153880
Name:WILLIAMS, MARCIA (APRN)
Entity type:Individual
Prefix:
First Name:MARCIA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 SE SANDIA WAY
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32025-3947
Mailing Address - Country:US
Mailing Address - Phone:352-817-0628
Mailing Address - Fax:
Practice Address - Street 1:345 W MADISON ST
Practice Address - Street 2:
Practice Address - City:STARKE
Practice Address - State:FL
Practice Address - Zip Code:32091-3923
Practice Address - Country:US
Practice Address - Phone:904-964-5455
Practice Address - Fax:904-964-4099
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11016185363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily