Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 5003973 | NC |
Y | 363L00000X | Nurse Practitioner | 5003973 | NC |
NPI | 1477710630 |
---|---|
Provider Name | Sondra Newhouse Williamson |
First Address | Pinehurst, NC 28374-8749 |
Second Address | Aberdeen, NC 28315-2382 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2008 |
Last Update Date | 18/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7004164 | (05) | NC |
P00726964 | RAILROAD MEDICARE (01) |