Provider Demographics
NPI:1104971209
Name:WILLIAMS, HOLLY MICHELLE (CNM, MSN)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:MICHELLE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CNM, MSN
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:MICHELLE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2711 FOSTER AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37210-5307
Mailing Address - Country:US
Mailing Address - Phone:615-227-3000
Mailing Address - Fax:
Practice Address - Street 1:107 CHARLES E DAVIS BLVD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37210-2745
Practice Address - Country:US
Practice Address - Phone:615-227-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN7440367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3380640Medicaid
TN3380640Medicaid