Provider Demographics
NPI:1225421472
Name:INMAN-WILLIAMSON, ELAINE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:
Last Name:INMAN-WILLIAMSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:ELAINE
Other - Middle Name:
Other - Last Name:INMAN-WILLIAMSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP - C
Mailing Address - Street 1:107 CHURCH AVE SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24011-1905
Mailing Address - Country:US
Mailing Address - Phone:540-853-2045
Mailing Address - Fax:
Practice Address - Street 1:107 CHURCH AVE SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24011-1905
Practice Address - Country:US
Practice Address - Phone:540-853-2045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-12
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024172415363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily