1366477804 NPI number — MS. BARBARA LYNN WILLIAMS MA, RD, LDN

Table of content: (NPI 1740227602)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366477804 NPI number — MS. BARBARA LYNN WILLIAMS MA, RD, LDN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WILLIAMS
Provider First Name:
BARBARA
Provider Middle Name:
LYNN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MA, RD, LDN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1366477804
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1717 COUNTY ROAD 220 APT 4001
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORANGE PARK
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32003-9130
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
904-375-1321
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
NAVAL HOSPITAL JACKSONVILLE
Provider Second Line Business Practice Location Address:
2080 CHILD STREET
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32214-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-542-9786
Provider Business Practice Location Address Fax Number:
904-542-9117
Provider Enumeration Date:
07/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 133V00000X , with the licence number:  LDN0000001491 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 798722 . This is a "AMERICAN DIETETIC ASSOCIA" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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