Provider Demographics
NPI:1093156309
Name:WILLIAMS, GIA MARIE
Entity type:Individual
Prefix:MISS
First Name:GIA
Middle Name:MARIE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11001 EXECUTIVE CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4393
Mailing Address - Country:US
Mailing Address - Phone:501-534-1300
Mailing Address - Fax:501-613-0848
Practice Address - Street 1:4200 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72114-6463
Practice Address - Country:US
Practice Address - Phone:501-534-1300
Practice Address - Fax:501-613-0848
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-15
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP120099363LF0000X
ARA003484363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily