Provider Demographics
NPI:1306943451
Name:WILLIAMSON, BARBARA ANN (NMW 956, NP6576, RN3)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ANN
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:NMW 956, NP6576, RN3
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1179 N. MCDOWELL BLVD
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94954
Mailing Address - Country:US
Mailing Address - Phone:707-559-7500
Mailing Address - Fax:707-559-7583
Practice Address - Street 1:1030 NEVIN AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94801-3122
Practice Address - Country:US
Practice Address - Phone:510-215-5001
Practice Address - Fax:510-215-1115
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA321816163WW0101X
CA6576363LW0102X
CA956367A00000X
CANMW956367A00000X
CANP6576364SW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No364SW0102XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ29609ZMedicare PIN
Q17041Medicare UPIN