Healthcare Provider Details

I. General information

NPI: 1902045321
Provider Name (Legal Business Name): LAURA E WILLIAMS CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2009
Last Update Date: 02/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 CENTRAL AVE
DOVER NH
03820-3437
US

IV. Provider business mailing address

770 CENTRAL AVE
DOVER NH
03820-3437
US

V. Phone/Fax

Practice location:
  • Phone: 603-742-0101
  • Fax: 603-743-3171
Mailing address:
  • Phone: 603-742-0101
  • Fax: 603-743-3171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number1841
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: