Provider Demographics
NPI:1588690069
Name:WILLIAMSON, RUTH ANN (MS RN FNP)
Entity type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:ANN
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:MS RN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2926 DUKESWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-8706
Mailing Address - Country:US
Mailing Address - Phone:972-414-1117
Mailing Address - Fax:
Practice Address - Street 1:2926 DUKESWOOD DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-8706
Practice Address - Country:US
Practice Address - Phone:972-414-1117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX536766363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX200359202Medicaid
TX8L8501Medicare PIN
TX8L8339Medicare PIN
TX8L8340Medicare PIN
TX8L8369Medicare PIN