Healthcare Provider Details

I. General information

NPI: 1487884995
Provider Name (Legal Business Name): ERIN MARIE WILLIAMSON R.N.,MSN,APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2009
Last Update Date: 05/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1145 S. UTICA AVE. SUITE 701
TULSA OK
74104
US

IV. Provider business mailing address

1145 S. UTICA AVE. SUITE 701
TULSA OK
74104
US

V. Phone/Fax

Practice location:
  • Phone: 918-582-6544
  • Fax: 918-582-6549
Mailing address:
  • Phone: 918-582-6544
  • Fax: 918-582-6549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number5374935091
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number106894
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: