Provider Demographics
NPI:1396480299
Name:GLORIA WILLIAMS FNP LLC
Entity type:Organization
Organization Name:GLORIA WILLIAMS FNP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:B
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:803-730-4221
Mailing Address - Street 1:889 ROYAL OAK WAY
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:SC
Mailing Address - Zip Code:29045-8012
Mailing Address - Country:US
Mailing Address - Phone:803-730-4221
Mailing Address - Fax:803-767-4971
Practice Address - Street 1:889 ROYAL OAK WAY
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:SC
Practice Address - Zip Code:29045-8012
Practice Address - Country:US
Practice Address - Phone:803-730-4221
Practice Address - Fax:803-767-4971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care