MR. SHANE CLINTON WILLIAMON I


Address: 901 Keith Avenue, Anniston, AL 36202
Phone: 2562368611

MR. SHANE CLINTON WILLIAMON I (NPI# 1881920353) 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) 1881920353
Entity Type Individual
Full Name MR. SHANE CLINTON WILLIAMON I
Credential CRNP
Practice Address 901 Keith Avenue
Anniston
AL 36202
Mailing Address P.o. Box 1890
Anniston
AL 36203
Practice Telephone 2562368611
Practice Fax Number 2562368636
Mailing Telephone 2562368611
Mailing Fax Number 2562368636
Enumeration Date 2009-10-19
Last Update Date 2009-10-19
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LA2100X Nurse Practitioner
Specialization: Acute Care
1-078396 AL Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 901 KEITH AVENUE
City ANNISTON
State AL
Zip Code 36202

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Taxonomy Information

Taxonomy Code 363LA2100X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Acute Care

Taxonomy Definition

Definition to come...

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Competitor

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City ANNISTON
Zip Code 36202

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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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