Basic Information
| Provider Information | |||||||||
| NPI: | 1013672856 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WILLIAMS | ||||||||
| FirstName: | ALLIE | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1249 COUNTY ROAD 1015 | ||||||||
| Address2: | |||||||||
| City: | CUNNINGHAM | ||||||||
| State: | KY | ||||||||
| PostalCode: | 420359428 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2702103376 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2605 KENTUCKY AVE STE 605 | ||||||||
| Address2: | |||||||||
| City: | PADUCAH | ||||||||
| State: | KY | ||||||||
| PostalCode: | 420033800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2705752100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/06/2021 | ||||||||
| LastUpdateDate: | 11/06/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/06/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 3016619 | KY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.