BLAKE MCCULLOUGH WILLIAMS (NPI# 1396363438) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396363438 |
| Entity Type | Individual |
| Full Name | BLAKE MCCULLOUGH WILLIAMS |
| Credential | FNP |
| Practice Address |
1017 N Pine St Deridder LA 70634-2817 |
| Mailing Address |
335 Carter Rd Dry Creek LA 70637-5029 |
| Practice Telephone | 3372024101 |
| Mailing Telephone | 3183084063 |
| Enumeration Date | 2020-07-06 |
| Last Update Date | 2020-07-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
214331 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245624626 | Blake C Williams | Nurse Practitioner | 1215 Pleasant St Ste 506, Des Moines, IA 50309-1418 | 2015-03-24 |
| 1942619275 | Blake Thomas Williams | Optometrist | 2394 H G Mosley Pkwy, Longview, TX 75604-3661 | 2014-08-12 |
| 1164764684 | Blake Kent Williams | Family Medicine | 780 Main St Ste 102, Great Barrington, MA 01230 | 2013-03-22 |
| 1326319419 | Blake Reed Williams | Counselor | 10593 Rockview Ct, Auburn, CA 95602 | 2012-01-20 |
| 1386814267 | Blake Aaron Williams | Chiropractor | 1211 12th Ave Se Ste 102, Dyersville, IA 52040-2412 | 2008-03-06 |
| 1932747342 | Blake Williams | Pharmacist | 4910 I 55 N, Jackson, MS 39211-5401 | 2019-12-16 |
| 1497101018 | Blake Williams | Ophthalmology | 5841 S Maryland Ave # Mc2114, Chicago, IL 60637-1447 | 2016-05-12 |
| 1194082057 | Blake Anthony Williams | Dermatology | 901 Se Plaza Ave, Suite 5, Bentonville, AR 72712-5697 | 2012-04-17 |
| Street Address |
1017 N PINE ST |
| City | DERIDDER |
| State | LA |
| Zip Code | 70634-2817 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194334433 | Julie E Thorn | Nurse Practitioner | 1017 N Pine St, Deridder, LA 70634-2817 | 2020-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861016164 | Just Health | Clinic/Center | 411 Bolivar Bishop Dr, Deridder, LA 70634 | 2020-06-02 |
| 1477193183 | Stacey Marie Legros | Occupational Therapy Assistant | 19503 Highway 171, Deridder, LA 70634 | 2020-01-10 |
| 1487296588 | Imperial Health LLP | Internal Medicine | 200 W 5th Street, Deridder, LA 70634 | 2019-10-10 |
| 1902367568 | Residential Therapy Solutions, LLC | Physical Therapist | 19503 Hwy 171, Deridder, LA 70634 | 2019-03-27 |
| 1023583044 | Calcasieu Urgent Care LLC | Clinic/Center | 1017 N Pine Street, Deridder, LA 70634 | 2018-10-05 |
| 1235638222 | Melanie Welch, Fnp, LLC | Nurse Practitioner | 1420 Blankenship Dr., Deridder, LA 70634 | 2018-02-06 |
| 1265976617 | Jennifer Dianne Midgett | Nurse Practitioner | 2581 Highway 190 W, Deridder, LA 70634 | 2016-12-05 |
| 1821419334 | Beauregard Hematolog & Oncology | Internal Medicine | 301 S. Washington St., Ste B, Deridder, LA 70634 | 2013-12-31 |
| 1982835013 | Kathern Sue Hollifield | Physical Therapist | 309 S. Washington St., Beauregard Physical Therapy Clinic Inc, Deridder, LA 70634 | 2009-08-06 |
| 1750541777 | Tracy Winkley | Physical Therapist | 1744 Ball Rd, Deridder, LA 70634 | 2008-06-12 |
| Find all providers in zip 70634 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225638737 | Dpdnp, LLC | Nurse Practitioner | 1264 Avenue Du Chateau, Covington, LA 70433-6423 | 2020-10-26 |
| 1700496429 | Kyur LLC | Nurse Practitioner | 1581 Carol Sue Ave Ste B, Gretna, LA 70056-5100 | 2020-08-06 |
| 1548870439 | Tamara Dianne Mcadams | Nurse Practitioner | 156 Bobby Johnson Rd, Farmerville, LA 71241-8138 | 2020-08-05 |
| 1699384099 | Health & Wellness Home Medical Services, LLC | Nurse Practitioner | 211 N 1st St Ste 2, Amite, LA 70422-2466 | 2020-07-31 |
| 1417565615 | Bobby D Chelette | Nurse Practitioner | 181 Hat Creek Dr, West Monroe, LA 71292-1031 | 2020-07-14 |
| 1730712605 | Christopher Aaron Sissell | Nurse Practitioner | 1850 Gause Blvd E Ste 103, Slidell, LA 70461-5454 | 2020-02-19 |
| 1790316610 | Perkins Nurse Practitioner Services | Nurse Practitioner | 9307 Melissa Way, Shreveport, LA 71115-2527 | 2020-01-29 |
| 1598305260 | Hollie Cavel Touchet | Nurse Practitioner | 116 Chicory Ln, Lafayette, LA 70506-9210 | 2020-01-10 |
| 1780228312 | Sharel Randolph Williams | Nurse Practitioner | 614 Harmony St, New Orleans, LA 70115-1108 | 2019-11-06 |
| 1992351365 | Rosemarie V Lazo | Nurse Practitioner | 13318 Berry Bowl Rd, Independence, LA 70443-2363 | 2019-08-12 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.