Provider Demographics
NPI:1417772278
Name:WILLIAMS, ROSETTA
Entity type:Individual
Prefix:
First Name:ROSETTA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:BERTRAND
Mailing Address - State:NE
Mailing Address - Zip Code:68927-1206
Mailing Address - Country:US
Mailing Address - Phone:308-472-3427
Mailing Address - Fax:
Practice Address - Street 1:503 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:BERTRAND
Practice Address - State:NE
Practice Address - Zip Code:68927-1206
Practice Address - Country:US
Practice Address - Phone:308-472-3427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider