Individual provider Active NPI

Elizabeth Williams-Henderson, APRN

  • Nurse Practitioner
  • Palm Bay, FL
National Provider Identifier
1700760089
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11041234 Issued in FL
Practice address
866 Du Bois Ave SE
Palm Bay, FL 32909-4349
Phone
(561) 676-5076
NPI assigned
Aug 1, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11041234 FL Primary

Addresses

Primary practice location

866 Du Bois Ave SE
Palm Bay, FL 32909-4349

Mailing address

866 Du Bois Ave SE
Palm Bay, FL 32909-4349

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

LicenseStateTypeSpecialty
APRN11041234FLMDNurse Practitioner

Interoperability endpoints

  • Direct secure messaging: elizabeth.williams-henderson.1@17832.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1754006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1700760089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "866 DU BOIS AVE SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329094349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "866 DU BOIS AVE SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329094349",
            "telephone_number": "561-676-5076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS-HENDERSON",
        "first_name": "ELIZABETH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-01",
        "last_updated": "2025-08-01",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11041234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2025; 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.