Active NPI
Kathleen Williams
- Adult Health Clinical Nurse Specialist
- Jackson, WY
National Provider Identifier
1679862833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Clinical Nurse Specialist
- License
- 1477
- Practice address
- 505 E Broadway Ave
Jackson, WY 83001-8640 - Phone
- (307) 739-7492
- NPI assigned
- Mar 28, 2011
- 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 |
|---|---|---|---|---|
| Adult Health Clinical Nurse Specialist | 364SA2200X | 1477 | WY | Primary |
Addresses
Primary practice location
505 E Broadway Ave
Jackson, WY 83001-8640
Mailing address
4430 Fallen Leaf LN
Jackson, WY 83001-8943
Phone (512) 517-7701
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1477 | WY | MD | Adult Health Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1301270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773100800000",
"number": "1679862833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4430 FALLEN LEAF LN",
"city": "JACKSON",
"state": "WY",
"postal_code": "830018943",
"telephone_number": "512-517-7701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 E BROADWAY AVE",
"city": "JACKSON",
"state": "WY",
"postal_code": "830018640",
"telephone_number": "307-739-7492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "KATHLEEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-03-28",
"last_updated": "2026-03-10",
"certification_date": "2026-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "364SA2200X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Adult Health",
"state": "WY",
"license": "1477",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.