Provider Demographics
NPI:1386130888
Name:WILLIAMS, PAIGE A (DNP, CRNA)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:A
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DNP, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 RUBY OAKS LN
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37128-0640
Mailing Address - Country:US
Mailing Address - Phone:618-516-1867
Mailing Address - Fax:
Practice Address - Street 1:2904 E STANFORD ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-2027
Practice Address - Country:US
Practice Address - Phone:618-516-1867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-08
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020012264367500000X
IL209018279367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered