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NPI Code Detail

MEDICARE: MR. NATHAN ALLEN WILLIAMSON APRN, NP-C

MEDICARE: MR. NATHAN ALLEN WILLIAMSON APRN, NP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerA004897AR

General Provider Information

NPI Number : 1306393061
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. NATHAN ALLEN WILLIAMSON APRN, NP-C
Provider Business Mailing Address
First Line : 9101 JENNY LIND RD
Second Line :
City : FORT SMITH
State : AR
Zip : 72908-9142
Country : US
Telephone Number : 479-274-6000
Fax Number : 479-484-4792
Provider Business Practice Location Address
First Line : 3700 CLIFF DR
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-5954
Country : US
Telephone Number : 479-259-9286
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2016
Last Update Date : 10/30/2019

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