Provider Demographics
NPI:1154788610
Name:WILLIAMS, ELIZABETH BOWEN (NP-C)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:BOWEN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:BOWEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3158 HALL CIR
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-3346
Mailing Address - Country:US
Mailing Address - Phone:678-637-8296
Mailing Address - Fax:
Practice Address - Street 1:975 JOHNSON FY RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1619
Practice Address - Country:US
Practice Address - Phone:678-637-8296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-28
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN225927363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily