Provider Demographics
NPI:1083021620
Name:WILLIAMS, AMBER R (PA-C, LAT, A TC)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:R
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PA-C, LAT, A TC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 THOMPSON ST STE C
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-2895
Mailing Address - Country:US
Mailing Address - Phone:828-694-7676
Mailing Address - Fax:828-694-7677
Practice Address - Street 1:212 THOMPSON ST STE C
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-2895
Practice Address - Country:US
Practice Address - Phone:828-694-7676
Practice Address - Fax:828-694-7677
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-15
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X
NC363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer