Provider Demographics
NPI:1346577616
Name:WILLIAMS, MICHELE (BSP)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:BSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 DAVIS DR
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8845
Mailing Address - Country:US
Mailing Address - Phone:919-468-6880
Mailing Address - Fax:
Practice Address - Street 1:3601 DAVIS DR
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-8845
Practice Address - Country:US
Practice Address - Phone:919-468-6880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-06
Last Update Date:2016-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15590183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist