Provider Demographics
NPI:1780072793
Name:WILLIAMS, ROSE (LM)
Entity type:Individual
Prefix:MS
First Name:ROSE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 RIO DULCE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79932-2359
Mailing Address - Country:US
Mailing Address - Phone:915-242-3533
Mailing Address - Fax:888-528-3587
Practice Address - Street 1:317 RIO DULCE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79932-2359
Practice Address - Country:US
Practice Address - Phone:915-242-3533
Practice Address - Fax:888-528-3587
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-27
Last Update Date:2014-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99182176B00000X
NM142128R176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife