Provider Demographics
NPI:1366809329
Name:WILLIAMS, CONSTANCE ANNA
Entity type:Individual
Prefix:MS
First Name:CONSTANCE
Middle Name:ANNA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10008 SPANISH CHERRY CT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3715
Mailing Address - Country:US
Mailing Address - Phone:813-340-4866
Mailing Address - Fax:813-374-2407
Practice Address - Street 1:10008 SPANISH CHERRY CT
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-3715
Practice Address - Country:US
Practice Address - Phone:813-340-4866
Practice Address - Fax:813-374-2407
Is Sole Proprietor?:No
Enumeration Date:2016-01-21
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9364264363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner