Provider Demographics
NPI:1972959625
Name:WILLIAMS, KAREN LYNN (NP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:LYNN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 S WALDRON RD STE 202
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-2598
Mailing Address - Country:US
Mailing Address - Phone:479-755-6900
Mailing Address - Fax:479-755-6903
Practice Address - Street 1:1501 S WALDRON RD STE 202
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-2598
Practice Address - Country:US
Practice Address - Phone:479-755-6900
Practice Address - Fax:479-755-6903
Is Sole Proprietor?:No
Enumeration Date:2016-05-12
Last Update Date:2021-01-13
Deactivation Date:2020-06-22
Deactivation Code:
Reactivation Date:2021-01-13
Provider Licenses
StateLicense IDTaxonomies
OKR0121121363LF0000X
OK121121363LF0000X
ARA004676363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200642430AMedicaid
AR224078758Medicaid