Basic Information
| Provider Information | |||||||||
| NPI: | 1770678765 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WILLIAMS | ||||||||
| FirstName: | ELIZABETH | ||||||||
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| Credential: | CPNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7 HOLLAND WAY FL 1 | ||||||||
| Address2: | |||||||||
| City: | EXETER | ||||||||
| State: | NH | ||||||||
| PostalCode: | 038332997 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6037728900 | ||||||||
| FaxNumber: | 6037720468 | ||||||||
| Practice Location | |||||||||
| Address1: | 9 BUZELL AVE | ||||||||
| Address2: | |||||||||
| City: | EXETER | ||||||||
| State: | NH | ||||||||
| PostalCode: | 038332522 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6037728900 | ||||||||
| FaxNumber: | 6037720468 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2006 | ||||||||
| LastUpdateDate: | 07/23/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | 047464-23 | NH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 002776101 | 01 | NH | MEDICARE | OTHER | 3077494 | 05 | NH | MEDICAID |