Provider Demographics
NPI:1457826372
Name:WILLIAMSON, ANDERSON WILEY (DNP, FNP)
Entity Type:Individual
Prefix:DR
First Name:ANDERSON
Middle Name:WILEY
Last Name:WILLIAMSON
Suffix:
Gender:M
Credentials:DNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 CHANNEL RUN
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27889-9249
Mailing Address - Country:US
Mailing Address - Phone:919-273-3573
Mailing Address - Fax:
Practice Address - Street 1:2000 VENTURE TOWER DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-2871
Practice Address - Country:US
Practice Address - Phone:866-439-3132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-07
Last Update Date:2018-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5011086363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily