Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | LM112 | AZ |
NPI | 1134628175 |
---|---|
Provider Name | Elizabeth Kate Williams |
First Address | Glendale, AZ 85308-9450 |
Second Address | Glendale, AZ 85308-9450 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2018 |
Last Update Date | 05/02/2018 |