Provider Demographics
NPI:1588543771
Name:WILLIAMS, KATHRYN INEZ (PMHNP)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:INEZ
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2290 LICK SKILLET RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30642-2220
Mailing Address - Country:US
Mailing Address - Phone:970-846-0964
Mailing Address - Fax:
Practice Address - Street 1:105 WESTPARK DR STE B-1
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-3174
Practice Address - Country:US
Practice Address - Phone:706-203-5216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-01
Last Update Date:2025-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN215669363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health