Genova L Williams, APRN, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Bradley, AR
NPI 1770041691 · NPPES record last updated Apr 7, 2025
Key facts
- NPI
- 1770041691
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- AP136038 (TX)
- Practice address
- 409 Woodruff St
Bradley, AR 71826-8715 - Phone
- (870) 330-6060
- Fax
- (501) 468-0497
- NPI assigned
- Mar 10, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX, AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190514000458 | TX | Practitioner - Nurse Practitioner | 0648513796 | Reassigns benefits to 1 organization |
| I20190716003452 | AR | Practitioner - Nurse Practitioner | 0648513796 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Access Medical Clinic Arkansas LLC | Current |
Accepting new patients | |
| Access Medical Clinic Arkansas LLC | Current | Accepting new patients | |
| Elizabeth Breedlove Family Practice & Aesthetics PLLC | Family | Current |
Accepting new patients |
| Access Medical Clinic Arkansas LLC | Current |
Accepting new patients |
Locations
409 Woodruff St
Bradley, AR 71826
Phone (870) 330-6060
2280 E Main St
El Dorado, AR 71730
Phone (870) 444-5216
16723 Highway 62
Garfield, AR 72732
Phone (870) 219-7706
4196 Highway 62 412
#A
Hardy, AR 72542
Phone (870) 856-2100
810 N Hill St
#2
Tatum, TX 75691
Phone (903) 241-0513
Interoperability endpoints
- genova.hansen.p1@direct.collom-carney.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP136038 | TX | Yes |
Addresses
Primary practice location
409 Woodruff St
Bradley, AR 71826-8715
Mailing address
4196 Highway 62 412 Ste a
Hardy, AR 72542-8002
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| F11170086 | Other | AANP FNP CERTIFICATION NUMBER | |
| 803397 | Other | TX | RN LICENSE NUMBER |
| AP136038 | Other | TX | APRN LICENSE NUMBER |
Other providers in Bradley, AR
- Bradley Public Schools
- Amanda Jean Ragland
- Southwest Arkansas Counseling and Mental Health Center, Inc
- Springhill Medical Services, Inc.
- Adrienne Staggs
All providers in Bradley, AR · Family Nurse Practitioner in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 7, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.