Provider Demographics
NPI:1962093492
Name:WILLIAMS, DENIS GAVIS (APRN-CNP)
Entity type:Individual
Prefix:MR
First Name:DENIS
Middle Name:GAVIS
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 W 4TH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-5146
Mailing Address - Country:US
Mailing Address - Phone:775-384-2189
Mailing Address - Fax:775-384-2254
Practice Address - Street 1:1155 W 4TH ST STE 103
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-5146
Practice Address - Country:US
Practice Address - Phone:775-384-2189
Practice Address - Fax:775-384-2254
Is Sole Proprietor?:No
Enumeration Date:2021-01-28
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV840246363LP0808X
NV83827363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1023741451Medicaid