Basic Information
| Provider Information | |||||||||
| NPI: | 1386287290 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ROSALIND SCOTT WILLIAMS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2921 TEAKWOOD LANDING DR | ||||||||
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| City: | SELLERSBURG | ||||||||
| State: | IN | ||||||||
| PostalCode: | 471728500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5022107915 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2818 GRANT LINE RD STE 2 | ||||||||
| Address2: | |||||||||
| City: | NEW ALBANY | ||||||||
| State: | IN | ||||||||
| PostalCode: | 471502492 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8129147038 | ||||||||
| FaxNumber: | 8129247661 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/23/2019 | ||||||||
| LastUpdateDate: | 10/23/2019 | ||||||||
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| AuthorizedOfficialLastName: | WILLIAMS | ||||||||
| AuthorizedOfficialFirstName: | ROSALIND | ||||||||
| AuthorizedOfficialMiddleName: | SCOTT | ||||||||
| AuthorizedOfficialTitleorPosition: | SOLE MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 5022107915 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | APRN | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.