Provider Demographics
NPI:1487884995
Name:WILLIAMSON, ERIN MARIE (RN,MSN,APRN)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:MARIE
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:RN,MSN,APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1145 S. UTICA AVE.
Mailing Address - Street 2:SUITE 701
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104
Mailing Address - Country:US
Mailing Address - Phone:918-582-6544
Mailing Address - Fax:918-582-6549
Practice Address - Street 1:1145 S. UTICA AVE.
Practice Address - Street 2:SUITE 701
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104
Practice Address - Country:US
Practice Address - Phone:918-582-6544
Practice Address - Fax:918-582-6549
Is Sole Proprietor?:No
Enumeration Date:2009-07-17
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5374935091363LA2200X
OK106894363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200458360AMedicaid
OKOKA106060Medicare PIN