Provider Demographics
NPI:1902494818
Name:WILLIAMSON, YASMA P (LPN)
Entity Type:Individual
Prefix:
First Name:YASMA
Middle Name:P
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3390 NE 9TH ST UNIT 101
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-5894
Mailing Address - Country:US
Mailing Address - Phone:305-910-1862
Mailing Address - Fax:
Practice Address - Street 1:3390 NE 9TH ST UNIT 101
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-5894
Practice Address - Country:US
Practice Address - Phone:305-910-1862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5238188164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty