Provider Demographics
NPI:1467280230
Name:WILLIAMS, MICHELLE DENISE (RN)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:DENISE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31581 GRATIOT AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-4528
Mailing Address - Country:US
Mailing Address - Phone:586-783-4802
Mailing Address - Fax:586-783-4805
Practice Address - Street 1:31581 GRATIOT AVE
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-4528
Practice Address - Country:US
Practice Address - Phone:586-783-4802
Practice Address - Fax:586-783-4805
Is Sole Proprietor?:No
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704388648163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)