Provider Demographics
NPI:1063581478
Name:WILLIAMS, LILLIAN WASHINGTON (CNS, FNP-BC)
Entity type:Individual
Prefix:MS
First Name:LILLIAN
Middle Name:WASHINGTON
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CNS, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5540 SHANON VW
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-1272
Mailing Address - Country:US
Mailing Address - Phone:770-947-9551
Mailing Address - Fax:
Practice Address - Street 1:5540 SHANON VW
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-1272
Practice Address - Country:US
Practice Address - Phone:770-947-9551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN120648363LF0000X, 364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Not Answered364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health