Provider Demographics
NPI:1164244414
Name:WILLIAMS, MARGERY (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:MARGERY
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3015 ALLISON LN
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48357-3160
Mailing Address - Country:US
Mailing Address - Phone:248-462-4219
Mailing Address - Fax:
Practice Address - Street 1:2809 MAYFAIR DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-2669
Practice Address - Country:US
Practice Address - Phone:248-243-6150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL-100915163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant