Basic Information
Provider Information | |||||||||
NPI: | 1821455155 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | WILLIAMSON | ||||||||
FirstName: | SHARON | ||||||||
MiddleName: |   | ||||||||
NamePrefix: | MS. | ||||||||
NameSuffix: |   | ||||||||
Credential: | APRN | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | STUDLEY | ||||||||
OtherFirstName: | SHARON | ||||||||
OtherMiddleName: | R | ||||||||
OtherNamePrefix: | MRS. | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 410 NW 32ND ST | ||||||||
Address2: |   | ||||||||
City: | GAINESVILLE | ||||||||
State: | FL | ||||||||
PostalCode: | 326072532 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3523396921 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 911 S MAIN ST | ||||||||
Address2: |   | ||||||||
City: | TRENTON | ||||||||
State: | FL | ||||||||
PostalCode: | 326933239 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3524632374 | ||||||||
FaxNumber: | 3524632726 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 01/17/2016 | ||||||||
LastUpdateDate: | 08/11/2021 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | Y | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 02/18/2021 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 1872042 | FL | N |   | Nursing Service Providers | Registered Nurse |   | 363LF0000X | APRN11011821 | FL | Y |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.