Provider Demographics
NPI:1871350348
Name:WILLIAMS, KATELYN (FNP-C)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36217 COUNTY ROAD 95
Mailing Address - Street 2:
Mailing Address - City:CROOK
Mailing Address - State:CO
Mailing Address - Zip Code:80726-9202
Mailing Address - Country:US
Mailing Address - Phone:970-630-8441
Mailing Address - Fax:
Practice Address - Street 1:302 S JEFFERS ST
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-5349
Practice Address - Country:US
Practice Address - Phone:308-534-6687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEF01241377207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine