Active NPI
Gwen Renee Williams, CNP
- Nurse Practitioner
- Las Cruces, NM
National Provider Identifier
1083610554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- R50209
- Practice address
- 1680 Calle de Alvarez
Ste B
Las Cruces, NM 88005-3821 - Phone
- (575) 524-3346
- Fax
- (575) 524-1720
- NPI assigned
- Jun 21, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R50209 | NM | Primary |
Addresses
Primary practice location
1680 Calle de Alvarez
Ste B
Las Cruces, NM 88005-3821
Mailing address
1680 Calle de Alvarez
Ste B
Las Cruces, NM 88005-3821
Phone (575) 524-3346
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 85174271 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R50209 | NM | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340236800000",
"number": "1083610554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1680 CALLE DE ALVAREZ",
"address_2": "STE B",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880053821",
"telephone_number": "575-524-3346",
"fax_number": "575-524-1720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1680 CALLE DE ALVAREZ",
"address_2": "STE B",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880053821",
"telephone_number": "575-524-3346",
"fax_number": "575-524-1720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "GWEN",
"middle_name": "RENEE",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-21",
"last_updated": "2012-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NM",
"license": "R50209",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "85174271",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Las Cruces, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.