Provider Demographics
NPI:1396080313
Name:WILLIAMS, CARLETTA C (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:CARLETTA
Middle Name:C
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3622 BELMONT AVE STE 20
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-1444
Mailing Address - Country:US
Mailing Address - Phone:348-550-0612
Mailing Address - Fax:234-855-0062
Practice Address - Street 1:3622 BELMONT AVE STE 20
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-1444
Practice Address - Country:US
Practice Address - Phone:348-550-0612
Practice Address - Fax:348-550-0622
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-02
Last Update Date:2024-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV26919363LF0000X
OH14241363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily