Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 1-10021 | AL |
NPI | 1033879309 |
---|---|
Provider Name | Rose Mary Williams Robinson |
First Address | Montgomery, AL 36105-6222 |
Second Address | Montgomery, AL 36109-3171 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2021 |
Last Update Date | 28/12/2021 |