Basic Information
| Provider Information | |||||||||
| NPI: | 1730557752 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WILLIAMS | ||||||||
| FirstName: | CIERRA | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1425 HIGHWAY 34 E | ||||||||
| Address2: | |||||||||
| City: | NEWNAN | ||||||||
| State: | GA | ||||||||
| PostalCode: | 302651323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7703043724 | ||||||||
| FaxNumber: | 7703043726 | ||||||||
| Practice Location | |||||||||
| Address1: | 1425 HIGHWAY 34 E | ||||||||
| Address2: | |||||||||
| City: | NEWNAN | ||||||||
| State: | GA | ||||||||
| PostalCode: | 302651323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7703043724 | ||||||||
| FaxNumber: | 7703043726 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/08/2015 | ||||||||
| LastUpdateDate: | 10/31/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/31/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | RN233631 | GA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 261QP2300X | RN233631 | GA | N | Ambulatory Health Care Facilities | Clinic/Center | Primary Care |
No ID Information.