Basic Information
Provider Information
NPI: 1265670160
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WILLIAMS
FirstName: ANGELA
MiddleName: MICHELLE
NamePrefix: MRS.
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 120 N MEDICAL DRIVE
Address2: UNC SCHOOL OF NURSING
City: CHAPEL HILL
State: NC
PostalCode: 27599
CountryCode: US
TelephoneNumber: 9199664260
FaxNumber:  
Practice Location
Address1: 120 N MEDICAL DRIVE
Address2: UNC SCHOOL OF NURSING
City: CHAPEL HILL
State: NC
PostalCode: 27599
CountryCode: US
TelephoneNumber: 9199664260
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/30/2009
LastUpdateDate: 08/08/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X210533NCN Nursing Service ProvidersRegistered Nurse 
171M00000X210533NCN Other Service ProvidersCase Manager/Care Coordinator 
363LP0808X5016654NCY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

ID Information
IDTypeStateIssuerDescription
21053301NCRN LICENSE NUMBEROTHER


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