Individual
MS. STACEY ANNE WILLIAMSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
4760 FASHION SQUARE BLVD STE L-1, SAGINAW, MI 48604-2620
(989) 282-4003
(888) 491-7220
Mailing address
801 ROSEHILL RD, JACKSON, MI 49202-1762
(989) 362-9411
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
69512
WV
363LF0000X
Family Nurse Practitioner
Primary
COA.13045-NP
OH
363LF0000X
Family Nurse Practitioner
RN.369896
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0112055
—
OH
05
—
3810028149
—
WV
Enumeration date
05/02/2012
Last updated
03/15/2023
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