Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | 510 | NM |
NPI | 1043245020 |
---|---|
Provider Name | Jennifer A Williams |
First Address | Albuquerque, NM 87125-6666 |
Second Address | Albuquerque, NM 87120-1710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 17/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
48839884 | (05) | NM |
Q11515 | (02) |