Provider Demographics
NPI:1215091715
Name:WILLIAMS, PATRICIA MCKEEVER (ARNP)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:MCKEEVER
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1302 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32177-5042
Mailing Address - Country:US
Mailing Address - Phone:386-326-7342
Mailing Address - Fax:386-325-1086
Practice Address - Street 1:460 PALM COAST PKWY SW
Practice Address - Street 2:SUITE 5
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-4785
Practice Address - Country:US
Practice Address - Phone:386-246-3954
Practice Address - Fax:386-246-3960
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1857002363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009677200Medicaid