Healthcare Provider Details

I. General information

NPI: 1932457553
Provider Name (Legal Business Name): PAMELA A WILLIAMSON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2012
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

698 E WETMORE RD STE 100
TUCSON AZ
85705
US

IV. Provider business mailing address

4800 N 22ND ST
PHOENIX AZ
85016-4701
US

V. Phone/Fax

Practice location:
  • Phone: 520-955-1000
  • Fax: 602-508-4830
Mailing address:
  • Phone: 602-955-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP10282
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN130008
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: