Provider Demographics
NPI:1528341187
Name:WILLIAMS, TRICIA ANNE (NP -C)
Entity type:Individual
Prefix:MRS
First Name:TRICIA
Middle Name:ANNE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NP -C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004-2929
Mailing Address - Country:US
Mailing Address - Phone:440-964-7121
Mailing Address - Fax:440-964-2251
Practice Address - Street 1:1111 LAKE AVE
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-2929
Practice Address - Country:US
Practice Address - Phone:440-964-7121
Practice Address - Fax:440-964-2251
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.12640 - NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health