Provider Demographics
NPI:1407094006
Name:WILLIAMS, URSULA UDUAK (CRNP-FAMILY)
Entity type:Individual
Prefix:
First Name:URSULA
Middle Name:UDUAK
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CRNP-FAMILY
Other - Prefix:
Other - First Name:URSULA
Other - Middle Name:PATRICK UDOSEN
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8907 MAYFLOWER ROAD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237
Mailing Address - Country:US
Mailing Address - Phone:410-918-9750
Mailing Address - Fax:410-918-1945
Practice Address - Street 1:8907 MAYFLOWER ROAD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237
Practice Address - Country:US
Practice Address - Phone:410-918-9750
Practice Address - Fax:410-918-1945
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR147024363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner