Provider Demographics
NPI:1437938842
Name:WILLIAMSON, HEATHER CAMILLE (APRN)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:CAMILLE
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1134 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MUNFORDVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42765-9432
Mailing Address - Country:US
Mailing Address - Phone:270-524-3641
Mailing Address - Fax:270-524-7595
Practice Address - Street 1:1134 MAIN ST
Practice Address - Street 2:
Practice Address - City:MUNFORDVILLE
Practice Address - State:KY
Practice Address - Zip Code:42765-9432
Practice Address - Country:US
Practice Address - Phone:270-524-3641
Practice Address - Fax:270-524-7595
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4009883363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily