Provider Demographics
NPI:1043414329
Name:WILLIAMS, KATHRYN FAULK (RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:FAULK
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1445 PIEDMONT DR
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-0264
Mailing Address - Country:US
Mailing Address - Phone:334-528-6800
Mailing Address - Fax:
Practice Address - Street 1:2422 VILLAGE PROFESSIONAL DRIVE
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-2378
Practice Address - Country:US
Practice Address - Phone:334-528-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1324133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered