Provider Demographics
NPI:1083940092
Name:WILLIAMS, RANELLE (CD, CPM)
Entity Type:Individual
Prefix:
First Name:RANELLE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CD, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1712 EDGEWATER PL
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80504-5236
Mailing Address - Country:US
Mailing Address - Phone:303-886-1282
Mailing Address - Fax:888-388-1283
Practice Address - Street 1:1712 EDGEWATER PL
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80504-5236
Practice Address - Country:US
Practice Address - Phone:303-886-1282
Practice Address - Fax:888-388-1283
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-26
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374J00000X
COCPM23030203367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No374J00000XNursing Service Related ProvidersDoula