Provider Demographics
NPI:1386028173
Name:WILLIAMS, CONNIE RENEA (ARNP-BC, MSN, BSN)
Entity type:Individual
Prefix:
First Name:CONNIE
Middle Name:RENEA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:ARNP-BC, MSN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:110 S WOODLAND ST
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-3546
Mailing Address - Country:US
Mailing Address - Phone:407-905-8827
Mailing Address - Fax:321-221-9454
Practice Address - Street 1:225 N 1ST ST
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-5150
Practice Address - Country:US
Practice Address - Phone:407-905-8827
Practice Address - Fax:352-360-2389
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9191785363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health