Provider Demographics
NPI:1326869827
Name:WILLIAMS, SHAKEDIA (ARNP)
Entity type:Individual
Prefix:MRS
First Name:SHAKEDIA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:ARNP
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 404
Mailing Address - Street 2:
Mailing Address - City:DONALSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:39845-0404
Mailing Address - Country:US
Mailing Address - Phone:229-220-1606
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 404
Practice Address - Street 2:
Practice Address - City:DONALSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:39845-0404
Practice Address - Country:US
Practice Address - Phone:229-220-1606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN234786363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily