Provider Demographics
NPI:1336787100
Name:WILLIAMS, KAWANA JEFFER (APRN, PHD, NP)
Entity type:Individual
Prefix:MRS
First Name:KAWANA
Middle Name:JEFFER
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:APRN, PHD, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1629 K ST NW STE 300
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006-1631
Mailing Address - Country:US
Mailing Address - Phone:240-620-1587
Mailing Address - Fax:
Practice Address - Street 1:3030 30TH ST SE APT 301
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-1657
Practice Address - Country:US
Practice Address - Phone:240-620-1587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-12
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1039613103TA0700X, 103TB0200X, 103TH0100X, 103TS0200X, 163WD0400X, 207RG0300X, 1744R1102X
VA0001264103103TH0100X, 163WC1500X
DC0001264103103TH0004X, 1744R1102X
MD0001264103103TS0200X, 163WA2000X, 163WD0400X
MDRN1039613163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1102XOther Service ProvidersSpecialistResearch Study
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD831540608Medicaid
DC1992339006Medicaid
DC1336787100Medicaid