Provider Demographics
NPI:1710023403
Name:WILLIAMSON, MARSHA S (CNM, MSN)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:S
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:CNM, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 DAVID DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45056-2519
Mailing Address - Country:US
Mailing Address - Phone:513-524-5798
Mailing Address - Fax:765-973-8220
Practice Address - Street 1:1104 S A ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-5526
Practice Address - Country:US
Practice Address - Phone:765-935-5525
Practice Address - Fax:465-935-7352
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN09000062A363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health