Provider Demographics
NPI:1689851727
Name:WILLIAMSON, CARRIE JO (LPN)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:JO
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:CARRIE
Other - Middle Name:JO
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9445 BELL RD
Mailing Address - Street 2:
Mailing Address - City:ADAMSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43802-9756
Mailing Address - Country:US
Mailing Address - Phone:740-221-0379
Mailing Address - Fax:
Practice Address - Street 1:9445 BELL RD
Practice Address - Street 2:
Practice Address - City:ADAMSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43802-9756
Practice Address - Country:US
Practice Address - Phone:740-221-0379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH123624164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse