Basic Information
| Provider Information | |||||||||
| NPI: | 1922299742 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WILLIAMSON | ||||||||
| FirstName: | JUDITH | ||||||||
| MiddleName: | LYNN | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | RN, APRN-BC, FNP, | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5666 E STATE ST | ||||||||
| Address2: | OSF SAINT ANTHONY MED. CENTER, CENTER FOR CANCER CARE | ||||||||
| City: | ROCKFORD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 611082425 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8152272663 | ||||||||
| FaxNumber: | 8152272658 | ||||||||
| Practice Location | |||||||||
| Address1: | 8940 N WOOD SAGE RD | ||||||||
| Address2: | |||||||||
| City: | PEORIA | ||||||||
| State: | IL | ||||||||
| PostalCode: | 616157822 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3092433000 | ||||||||
| FaxNumber: | 3092433063 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/06/2007 | ||||||||
| LastUpdateDate: | 04/09/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 309-001477 | IL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.