Provider Demographics
NPI:1427163971
Name:WILLIAMS, ALLYSON NICHOLE (ARNP)
Entity type:Individual
Prefix:MS
First Name:ALLYSON
Middle Name:NICHOLE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41701-1920
Mailing Address - Country:US
Mailing Address - Phone:606-487-9505
Mailing Address - Fax:606-436-0071
Practice Address - Street 1:279 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701-1920
Practice Address - Country:US
Practice Address - Phone:606-487-9505
Practice Address - Fax:606-436-0071
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3004940363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78016946Medicaid
KY78016946Medicaid