| Doctor Name: | MRS. KELLY TAYLOR WILLIAMSON |
| NPI Number: | 1134461171 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSN, APRN, BC |
| License Number: | 18196 |
| Business Practice Address: | 704 Gold Hill Rd Suite 107 Fort Mill, SC - 297158906 |
| Business Phone Number: | 8038350420 |
| Business Fax Number: | 7045122231 |
| Mailing Address: | Po Box 602120, Suite 107 CHARLOTTE |
| State: | NC |
| Postal Code: | 282602120 |
| Phone Number: | 8038350420 |
| Fax Number: | 7045122231 |
| NPI Enumeration Date: | 03/17/2013 |
| NPI Last Update Date: | 05/08/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 18196 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |