Provider Demographics
NPI:1043852544
Name:WILLIAMSON, CHRISTY BROOKE (DCN, CNS, LDN, MS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTY
Middle Name:BROOKE
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:DCN, CNS, LDN, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16521 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23838-1638
Mailing Address - Country:US
Mailing Address - Phone:804-337-9820
Mailing Address - Fax:
Practice Address - Street 1:16521 RIVER RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23838-1638
Practice Address - Country:US
Practice Address - Phone:804-337-9820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-16
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA17227133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist