Angela Lynne Williams, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

20111693 Issued in OK

Practice address

3300 S Aspen Ave Ste B
Broken Arrow, OK 74012-7501

Phone

(918) 455-4140

Fax

(918) 455-0170

NPI assigned

Oct 4, 2012

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

Credentials

Certified Pediatric Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Aspen Children'S Clinic of Broken Arrow Inc.

  • Primary Care Clinic/Center
  • Broken Arrow, OK
  • NPI 1144363094
  NPD (past)

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

{
    "created_epoch": "1349308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1558613356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S ASPEN AVE STE B",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740127501",
            "telephone_number": "918-455-4140",
            "fax_number": "918-455-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 S ASPEN AVE STE B",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740127501",
            "telephone_number": "918-455-4140",
            "fax_number": "918-455-0170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ANGELA",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-04",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OK",
            "license": "86448",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OK",
            "license": "20111693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy Leigh Wilde, BA
• Melinda Lee Wilkin, MSC SLT, BCBA
• Dakota Wilkinson
• Courtney Brooke Willcoxon, PHARMD
• Alisha Sheree Williams, RMA/PHLEBOTOMY
• Angela Nicole Williams
• Bobbie Williams
• Donna Phillips Williams, ARNP
• Jenna Williams
• Kacee Don Williams, D.PH.

• Pediatric Nurse Practitioner in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Pediatric Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; 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.