Provider Demographics
NPI:1336326560
Name:WILLIAMSON, JOHN MICHAEL (DNP, FNP-C, ARM-BC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MICHAEL
Last Name:WILLIAMSON
Suffix:
Gender:M
Credentials:DNP, FNP-C, ARM-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1154 CROSS CREEK DR
Mailing Address - Street 2:
Mailing Address - City:SALTILLO
Mailing Address - State:MS
Mailing Address - Zip Code:38866-5777
Mailing Address - Country:US
Mailing Address - Phone:662-840-8010
Mailing Address - Fax:
Practice Address - Street 1:1154 CROSS CREEK DR
Practice Address - Street 2:
Practice Address - City:SALTILLO
Practice Address - State:MS
Practice Address - Zip Code:38866-5777
Practice Address - Country:US
Practice Address - Phone:662-840-8010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2023-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC003026363LF0000X
MSR853568363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily