Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 4007001 | NY |
NPI | 1013053214 |
---|---|
Provider Name | Ms. Rosie Williams |
First Address | Rochester, NY 14609-5122 |
Second Address | Rochester, NY 14609-7402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2007 |
Last Update Date | 08/07/2007 |