Provider Demographics
NPI:1790703833
Name:WILLIAMSON, RONDA D (FNP BC)
Entity Type:Individual
Prefix:
First Name:RONDA
Middle Name:D
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:FNP BC
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Mailing Address - Street 1:210 E DERENNE AVE
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405
Mailing Address - Country:US
Mailing Address - Phone:912-644-5300
Mailing Address - Fax:912-644-5260
Practice Address - Street 1:36671 HIGHWAY 23
Practice Address - Street 2:
Practice Address - City:COBBTOWN
Practice Address - State:GA
Practice Address - Zip Code:30420-6042
Practice Address - Country:US
Practice Address - Phone:912-684-2071
Practice Address - Fax:912-684-2074
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2014-06-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GARN072778 NP363LF0000X
GARN072778363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA723799683BMedicaid