Provider Demographics
NPI:1699328534
Name:WILLIAMSON, TIFFANY ANN (APRN, AGNP-C)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:ANN
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:APRN, AGNP-C
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:DEAN
Other - Last Name:WILLIAMSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7050 W PALMETTO PARK RD STE 15-513
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3426
Mailing Address - Country:US
Mailing Address - Phone:954-501-3861
Mailing Address - Fax:608-305-8874
Practice Address - Street 1:9500 NW 49TH CT
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33076-2465
Practice Address - Country:US
Practice Address - Phone:954-501-3861
Practice Address - Fax:608-305-8874
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-19
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11003436363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty