Provider Demographics
NPI:1093875130
Name:WILLIAMS, KRISTI LYNN (NURSE LPN)
Entity Type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:LYNN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NURSE LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8939 HIGHWAY 95
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN GROVE
Mailing Address - State:MO
Mailing Address - Zip Code:65711-2885
Mailing Address - Country:US
Mailing Address - Phone:417-668-5537
Mailing Address - Fax:417-668-5537
Practice Address - Street 1:8939 HIGHWAY 95
Practice Address - Street 2:
Practice Address - City:MOUNTAIN GROVE
Practice Address - State:MO
Practice Address - Zip Code:65711-2885
Practice Address - Country:US
Practice Address - Phone:417-668-5537
Practice Address - Fax:417-668-5537
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)