Provider Demographics
NPI:1497502371
Name:WILLIAMSON-BROWN, YASHICA LATRELL (RN)
Entity type:Individual
Prefix:
First Name:YASHICA
Middle Name:LATRELL
Last Name:WILLIAMSON-BROWN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 BIRD AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14213-1228
Mailing Address - Country:US
Mailing Address - Phone:716-310-4729
Mailing Address - Fax:
Practice Address - Street 1:310 BIRD AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14213-1228
Practice Address - Country:US
Practice Address - Phone:716-310-4729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY478125163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse