Provider Demographics
NPI:1073558334
Name:MCWILLIAMS, SONYA RENEE (FNP)
Entity type:Individual
Prefix:
First Name:SONYA
Middle Name:RENEE
Last Name:MCWILLIAMS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1934 ALCOA HWY
Mailing Address - Street 2:BLDG D SUITE 285
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1524
Mailing Address - Country:US
Mailing Address - Phone:865-305-9620
Mailing Address - Fax:
Practice Address - Street 1:1934 ALCOA HWY
Practice Address - Street 2:BLDG D SUITE 285
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1524
Practice Address - Country:US
Practice Address - Phone:865-305-9620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN7945363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN500025628OtherRR MEDICARE PIN
TN3909656Medicaid
P44827Medicare UPIN
TN3714825Medicare ID - Type UnspecifiedLEGACY GROUP
TN3909656Medicaid