Provider Demographics
NPI:1285877258
Name:WILLIAMS, TAMMY JEAN (ARNP)
Entity type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:JEAN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:MORRIS
Other - Last Name:BROCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8594 SW 113TH AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE BUTLER
Mailing Address - State:FL
Mailing Address - Zip Code:32054-7471
Mailing Address - Country:US
Mailing Address - Phone:904-482-2380
Mailing Address - Fax:
Practice Address - Street 1:1801 N TEMPLE AVE
Practice Address - Street 2:
Practice Address - City:STARKE
Practice Address - State:FL
Practice Address - Zip Code:32091-1960
Practice Address - Country:US
Practice Address - Phone:904-964-7732
Practice Address - Fax:904-964-3829
Is Sole Proprietor?:No
Enumeration Date:2009-04-07
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2613912363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily