Healthcare Provider Details

I. General information

NPI: 1851906119
Provider Name (Legal Business Name): JENNIFER KAYE WILLIAMSON FNP-C, WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2020
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 24TH ST
FORT LEE VA
23801-1716
US

IV. Provider business mailing address

700 24TH ST
FORT LEE VA
23801-1716
US

V. Phone/Fax

Practice location:
  • Phone: 804-734-6262
  • Fax:
Mailing address:
  • Phone: 804-734-6262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0997904-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: