Provider Demographics
NPI:1477710630
Name:WILLIAMSON, SONDRA NEWHOUSE (ANP)
Entity Type:Individual
Prefix:
First Name:SONDRA
Middle Name:NEWHOUSE
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 PAGE RD
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-8749
Mailing Address - Country:US
Mailing Address - Phone:910-295-5511
Mailing Address - Fax:
Practice Address - Street 1:1902 N SANDHILLS BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:ABERDEEN
Practice Address - State:NC
Practice Address - Zip Code:28315-2382
Practice Address - Country:US
Practice Address - Phone:910-692-4011
Practice Address - Fax:910-695-1751
Is Sole Proprietor?:No
Enumeration Date:2008-05-16
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5003973207QH0002X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7004164Medicaid
P00726964OtherRAILROAD MEDICARE
2593345Medicare PIN