Provider Demographics
NPI:1144000829
Name:WILLIAMS, CHRISTINE ROSE (PA-C)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ROSE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 COUNTY ST
Mailing Address - Street 2:
Mailing Address - City:MILAN
Mailing Address - State:MI
Mailing Address - Zip Code:48160-1502
Mailing Address - Country:US
Mailing Address - Phone:734-646-8633
Mailing Address - Fax:
Practice Address - Street 1:240 COUNTY ST
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:MI
Practice Address - Zip Code:48160-1502
Practice Address - Country:US
Practice Address - Phone:734-646-8633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant