Individual provider Active NPI

Nicollette Williams, NNP

  • Neonatal Nurse Practitioner
  • Spokane, WA
National Provider Identifier
1407528599
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
61226970 Issued in WA
Practice address
101 W 8TH Ave
Spokane, WA 99204-2307
Phone
(509) 474-3131
NPI assigned
Sep 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 61226970 WA Primary

Addresses

Primary practice location

101 W 8TH Ave
Spokane, WA 99204-2307

Mailing address

7105 S Holly St
Cheney, WA 99004-5376
Phone (720) 456-2533

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220215001810 WA Order and Referring Only - Nurse Practitioner 4981097938

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61226970WAMDNeonatal Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: nherman637012@direct.multicare.org

NPI Registry JSON

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

{
    "created_epoch": "1632787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1407528599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7105 S HOLLY ST",
            "city": "CHENEY",
            "state": "WA",
            "postal_code": "990045376",
            "telephone_number": "720-456-2533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W 8TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042307",
            "telephone_number": "509-474-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "NICOLLETTE",
        "credential": "NNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-28",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "WA",
            "license": "61226970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.