Provider Demographics
NPI:1033770896
Name:WILLIAMS, KIMBERLY CRISTOL (RN, IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:CRISTOL
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 1:2363 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-2211
Mailing Address - Country:US
Mailing Address - Phone:703-855-7581
Mailing Address - Fax:
Practice Address - Street 1:4927 AUBURN AVE STE 100
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-2641
Practice Address - Country:US
Practice Address - Phone:301-943-9293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001142466163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant