Provider Demographics
NPI:1093870701
Name:WILLIAMS, MARJORIE ROSE (APRN, PC)
Entity Type:Individual
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First Name:MARJORIE
Middle Name:ROSE
Last Name:WILLIAMS
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Gender:F
Credentials:APRN, PC
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Mailing Address - Street 1:280 CHESTNUT ST
Mailing Address - Street 2:2ND FL
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1001
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:3300 MAIN ST
Practice Address - Street 2:4TH FL
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1112
Practice Address - Country:US
Practice Address - Phone:413-794-7284
Practice Address - Fax:413-794-7140
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2016-11-14
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Provider Licenses
StateLicense IDTaxonomies
MA120015363LP0808X, 364SP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0807XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Adolescent
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health