Provider Demographics
NPI:1063989614
Name:WILLIAMS, NATASHA ALICIA (NP-C)
Entity type:Individual
Prefix:DR
First Name:NATASHA
Middle Name:ALICIA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MISS
Other - First Name:NATASHA
Other - Middle Name:ALICIA
Other - Last Name:LEAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:2 MURRAY CIR
Mailing Address - Street 2:
Mailing Address - City:CHERAW
Mailing Address - State:SC
Mailing Address - Zip Code:29520-1610
Mailing Address - Country:US
Mailing Address - Phone:843-910-5018
Mailing Address - Fax:
Practice Address - Street 1:2 MURRAY CIR
Practice Address - Street 2:
Practice Address - City:CHERAW
Practice Address - State:SC
Practice Address - Zip Code:29520-1610
Practice Address - Country:US
Practice Address - Phone:843-910-5018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-31
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22302363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily