Provider Demographics
NPI:1306393061
Name:WILLIAMSON, NATHAN ALLEN (APRN, NP-C)
Entity type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:ALLEN
Last Name:WILLIAMSON
Suffix:
Gender:M
Credentials:APRN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9101 JENNY LIND RD
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72908-9142
Mailing Address - Country:US
Mailing Address - Phone:479-274-6000
Mailing Address - Fax:479-484-4792
Practice Address - Street 1:3700 CLIFF DR
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-5954
Practice Address - Country:US
Practice Address - Phone:479-259-9286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-09
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004897363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily