Provider Demographics
NPI:1598159824
Name:WILLIAMSON, TREESA (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:TREESA
Middle Name:
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 DICKINSON DR STE 107
Mailing Address - Street 2:
Mailing Address - City:CHADDS FORD
Mailing Address - State:PA
Mailing Address - Zip Code:19317-9689
Mailing Address - Country:US
Mailing Address - Phone:610-361-9500
Mailing Address - Fax:610-361-9501
Practice Address - Street 1:161 CECIL B MOORE AVE APT 204
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19122-3243
Practice Address - Country:US
Practice Address - Phone:215-585-2144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-25
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014874363L00000X
PASP026787363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1031853220001Medicaid