Jennifer Williams, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2020032732 Issued in MO

Practice address

452 Sovereign CT Ste a
Ballwin, MO 63011-4447

Phone

(636) 222-8699

Fax

(636) 238-5434

NPI assigned

Dec 12, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1481500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1063956944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4858 ALLEMANIA ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631161006",
            "telephone_number": "314-373-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "452 SOVEREIGN CT STE A",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630114447",
            "telephone_number": "636-222-8699",
            "fax_number": "636-238-5434"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4066 Dunnica Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631163510",
            "country_code": "US",
            "telephone_number": "636-224-1230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JENNIFER",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-12",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "132226",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2020032732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Marie Wickline, AGNP
• Charles Wight, RBT
• Beverly Ann Wilhelm-Oney, MD
• Ashley Nicole Williams-Farmer, DO
• Grace Ann Williams
• Page K Williams, RN
• Sarah Lyn Willis, RPH
• Jessica Elizabeth Willmann, PLPC
• Brandi Nicole Wilson, PLPC
• Kyle Winters

• Family Nurse Practitioner in Ballwin, MO
• Providers in Ballwin, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.