Provider Demographics
NPI:1003127143
Name:WILLIAMSON, ANNETTE DIANE (ARNP, FNP)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:DIANE
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:ARNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 SPRINGDALE RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-4259
Mailing Address - Country:US
Mailing Address - Phone:816-882-7621
Mailing Address - Fax:
Practice Address - Street 1:2205 N TARRANT PKWY
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76177-2204
Practice Address - Country:US
Practice Address - Phone:817-328-3320
Practice Address - Fax:817-328-3325
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1042904363LF0000X
KS53-75136-052363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily