Healthcare Provider Details

I. General information

NPI: 1801839022
Provider Name (Legal Business Name): SANDRA PAULA WILLIAMSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VETERANS AFFAIRS MEDICAL CENTER 1055 CLERMONT ST #117
DENVER CO
80220
US

IV. Provider business mailing address

3563 CRAFTSBURY DR
LITTLETON CO
80126-7534
US

V. Phone/Fax

Practice location:
  • Phone: 303-399-8020
  • Fax: 303-393-5164
Mailing address:
  • Phone: 303-474-0689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number84231
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: