Provider Demographics
NPI:1528689155
Name:WILLIAMS, DAHNIDE MARIE (NP)
Entity type:Individual
Prefix:MRS
First Name:DAHNIDE
Middle Name:MARIE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:DAHNIDE
Other - Middle Name:MARIE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:667 LAKEWATER ESTATES LN
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-4999
Mailing Address - Country:US
Mailing Address - Phone:770-377-6479
Mailing Address - Fax:
Practice Address - Street 1:667 LAKEWATER ESTATES LN
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-4999
Practice Address - Country:US
Practice Address - Phone:770-377-6479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-05
Last Update Date:2021-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN190858363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily