Provider Demographics
NPI:1538596572
Name:WILLIAMS, JENNIFER LOUISA (CPM)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LOUISA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13694 E SHADY MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47403-6203
Mailing Address - Country:US
Mailing Address - Phone:812-369-0916
Mailing Address - Fax:
Practice Address - Street 1:13694 E SHADY MEADOWS DR
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47403-6203
Practice Address - Country:US
Practice Address - Phone:812-369-0916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-04
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife