Provider Demographics
NPI:1699161562
Name:DENIESE WILLIAMS LLC
Entity type:Organization
Organization Name:DENIESE WILLIAMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:DENIESE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:754-245-5480
Mailing Address - Street 1:6526 S KANNER HWY
Mailing Address - Street 2:UNIT 221
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-6396
Mailing Address - Country:US
Mailing Address - Phone:754-245-5480
Mailing Address - Fax:
Practice Address - Street 1:6526 S KANNER HWY
Practice Address - Street 2:UNIT 221
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-6396
Practice Address - Country:US
Practice Address - Phone:754-245-5480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-08
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 2886402363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty