Provider Demographics
NPI:1124586086
Name:WILLIAMS, ANGANATTE NICOLE (MSN, CRNP, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:ANGANATTE
Middle Name:NICOLE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MSN, CRNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22389
Mailing Address - Street 2:PMB 82739
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37202
Mailing Address - Country:US
Mailing Address - Phone:866-315-2626
Mailing Address - Fax:
Practice Address - Street 1:2318 ST. STEPHENS RD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36617
Practice Address - Country:US
Practice Address - Phone:251-308-5689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-08
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS903475363LF0000X
AL1-137652363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03006815Medicaid