Provider Demographics
NPI:1033879309
Name:WILLIAMS ROBINSON, ROSE MARY
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:MARY
Last Name:WILLIAMS ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3066 BUTLER MILL RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36105-6222
Mailing Address - Country:US
Mailing Address - Phone:334-669-3959
Mailing Address - Fax:
Practice Address - Street 1:4367 ATLANTA HWY STE C
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36109-3171
Practice Address - Country:US
Practice Address - Phone:334-676-2797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-10021363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care