Provider Demographics
NPI:1699105569
Name:WILLIAMSON, ARCHIE (R N)
Entity type:Individual
Prefix:MR
First Name:ARCHIE
Middle Name:
Last Name:WILLIAMSON
Suffix:
Gender:M
Credentials:R N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 DRUM AVE
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-3952
Mailing Address - Country:US
Mailing Address - Phone:240-300-2490
Mailing Address - Fax:202-829-9192
Practice Address - Street 1:1707 L ST NW
Practice Address - Street 2:SUITE 900
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-4201
Practice Address - Country:US
Practice Address - Phone:202-829-1111
Practice Address - Fax:202-829-9192
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-13
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN65223163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health