Provider Demographics
NPI:1659962355
Name:WILLIAMSON, CAROL L
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:L
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 BANEBERRY LN
Mailing Address - Street 2:
Mailing Address - City:ROMNEY
Mailing Address - State:WV
Mailing Address - Zip Code:26757-4645
Mailing Address - Country:US
Mailing Address - Phone:681-231-9119
Mailing Address - Fax:
Practice Address - Street 1:9 BANEBERRY LN
Practice Address - Street 2:
Practice Address - City:ROMNEY
Practice Address - State:WV
Practice Address - Zip Code:26757-4645
Practice Address - Country:US
Practice Address - Phone:681-231-9119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant