Provider Demographics
NPI:1033526363
Name:WILLIAMS, ROSLYN (NP)
Entity Type:Individual
Prefix:
First Name:ROSLYN
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:9501 E HIGHLAND RD
Mailing Address - Street 2:APT 277
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-5002
Mailing Address - Country:US
Mailing Address - Phone:313-243-4425
Mailing Address - Fax:
Practice Address - Street 1:315 E EISENHOWER PKWY
Practice Address - Street 2:SUITE 7
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-3350
Practice Address - Country:US
Practice Address - Phone:734-222-8200
Practice Address - Fax:734-222-8202
Is Sole Proprietor?:No
Enumeration Date:2014-07-18
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704232829363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4704232829OtherNP LICENSE NUMBER