GLORIA WILLIAMSON SR.


Address: 4651 Sw Nackman Ter, 4015 Sw Melbourne St, Port Saint Lucie, FL 34953-5581
Phone: 7722042177

GLORIA WILLIAMSON SR. (NPI# 1821454141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1821454141
Entity Type Individual
Full Name GLORIA WILLIAMSON SR.
Credential NP
Practice Address 4651 Sw Nackman Ter
4015 Sw Melbourne St
Port Saint Lucie
FL 34953-5581
Mailing Address 4651 Sw Nackman Ter
Port Saint Lucie
FL 34953-5581
Practice Telephone 7722042177
Mailing Telephone 7722042177
Enumeration Date 2016-01-04
Last Update Date 2016-01-04
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LG0600X Nurse Practitioner
Specialization: Gerontology
ARNP9243012 FL Physician Assistants & Advanced Practice Nursing Providers

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1053614990 Gloria Marie Williamson Dietitian, Registered 620 N Lake Ave, Pasadena, CA 91101-1220 2010-12-15
1871627638 Gloria Diane Williamson Registered Nurse 11533 C Ave, Auburn, CA 95603-2703 2007-03-15

Office Location

Street Address 4651 SW NACKMAN TER
4015 SW MELBOURNE ST
City PORT SAINT LUCIE
State FL
Zip Code 34953-5581

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Taxonomy Information

Taxonomy Code 363LG0600X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Gerontology

Taxonomy Definition

Definition to come...

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Competitor

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City PORT SAINT LUCIE
Zip Code 34953

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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