Provider Demographics
NPI:1336371863
Name:WILLIAMS, VICTORIA RENEE' (APN-FNP)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:RENEE'
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:APN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 GREENE 629
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-8091
Mailing Address - Country:US
Mailing Address - Phone:870-450-2424
Mailing Address - Fax:
Practice Address - Street 1:1000 W KINGSHIGHWAY
Practice Address - Street 2:SUITE #4
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-4141
Practice Address - Country:US
Practice Address - Phone:870-239-3225
Practice Address - Fax:870-239-3595
Is Sole Proprietor?:No
Enumeration Date:2009-08-17
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03278363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily