Provider Demographics
NPI:1871392316
Name:WILLIAMS, KATHERINE DENESE (APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:DENESE
Last Name:WILLIAMS
Suffix:
Gender:
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 NW KATHY GLN
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32055-5317
Mailing Address - Country:US
Mailing Address - Phone:352-514-6569
Mailing Address - Fax:
Practice Address - Street 1:2786 W US HIGHWAY 90 STE 105
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32055-7723
Practice Address - Country:US
Practice Address - Phone:386-758-2944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11038088363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily