Individual provider · NPI-1

Portia Williams, APRN

Nurse Practitioner · Port St Lucie, FL

NPI number1295344604
StatusActive
Last updated in NPPESMar 7, 2021

Details

NPI
1295344604
Entity type
Individual (NPI-1)
Name
Portia Williams
Credential
APRN
Sex
Female
Sole proprietor
Yes
Enumeration date
Jul 31, 2020
Certification date
Mar 7, 2021
Last updated
Mar 7, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363L00000X Nurse Practitioner11010453FLYes
163WG0000X Registered Nurse, General Practice9322322FL

Other names

  • Portia Boatwright (Former Name)

Practice location

2225 Sw Newport Isles Blvd
Port St Lucie, FL 34953-4575

Phone 561-633-0104 · Fax 888-411-5724

Mailing address

2225 Sw Newport Isles Blvd
Port St Lucie, FL 34953-4575

Phone 561-633-0104 · Fax 888-411-5724

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