Healthcare Provider Details

I. General information

NPI: 1669699229
Provider Name (Legal Business Name): JEAN P WILLIAMSON R.N., B.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 HARRY TRUMAN PARKWAY
ANNAPOLIS MD
21401
US

IV. Provider business mailing address

6568 CLAGETT AVE
TRACYS LANDING MD
20779-2528
US

V. Phone/Fax

Practice location:
  • Phone: 410-222-7004
  • Fax:
Mailing address:
  • Phone: 410-257-9163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberR108264
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: