Basic Information
Provider Information
NPI: 1356824304
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WILLIAMS
FirstName: FRANCINE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 130 S BRYN MAWR AVE
Address2:  
City: BRYN MAWR
State: PA
PostalCode: 190103121
CountryCode: US
TelephoneNumber: 4843374286
FaxNumber: 4843374293
Practice Location
Address1: 130 S BRYN MAWR AVE
Address2:  
City: BRYN MAWR
State: PA
PostalCode: 190103121
CountryCode: US
TelephoneNumber: 4843374286
FaxNumber: 4843374293
Other Information
ProviderEnumerationDate: 09/14/2018
LastUpdateDate: 11/05/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN662613PAN Nursing Service ProvidersRegistered Nurse 
363LP0808XSP019413PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


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