Provider Demographics
NPI:1881996445
Name:WILLIAMSON, LIONEL (FNP)
Entity type:Individual
Prefix:
First Name:LIONEL
Middle Name:
Last Name:WILLIAMSON
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 DOUGLAS BLVD
Mailing Address - Street 2:STE 325
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-4289
Mailing Address - Country:US
Mailing Address - Phone:916-241-9844
Mailing Address - Fax:
Practice Address - Street 1:8325 ELK GROVE FLORIN RD STE 800
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95829-9524
Practice Address - Country:US
Practice Address - Phone:916-226-6190
Practice Address - Fax:916-689-5038
Is Sole Proprietor?:No
Enumeration Date:2010-12-02
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20422363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily