Provider Demographics
NPI:1740848639
Name:WILLIAMSON, MACY (CRNP)
Entity type:Individual
Prefix:
First Name:MACY
Middle Name:
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:MACY
Other - Middle Name:
Other - Last Name:OWENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1704 S FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:LUVERNE
Mailing Address - State:AL
Mailing Address - Zip Code:36049-7306
Mailing Address - Country:US
Mailing Address - Phone:334-335-3383
Mailing Address - Fax:334-335-3078
Practice Address - Street 1:1704 S FOREST AVE
Practice Address - Street 2:
Practice Address - City:LUVERNE
Practice Address - State:AL
Practice Address - Zip Code:36049-7306
Practice Address - Country:US
Practice Address - Phone:334-335-3383
Practice Address - Fax:334-335-3078
Is Sole Proprietor?:No
Enumeration Date:2019-06-05
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-145338207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine