Provider Demographics
NPI:1235442484
Name:WILLIAMS-CRETS, ANGELA (RD)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:
Last Name:WILLIAMS-CRETS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1151 MAIN STREET
Mailing Address - Street 2:P.O. BOX 100
Mailing Address - City:SWAN QUARTER
Mailing Address - State:NC
Mailing Address - Zip Code:27885
Mailing Address - Country:US
Mailing Address - Phone:252-926-4379
Mailing Address - Fax:252-926-3702
Practice Address - Street 1:1151 MAIN STREET
Practice Address - Street 2:
Practice Address - City:SWAN QUARTER
Practice Address - State:NC
Practice Address - Zip Code:27885
Practice Address - Country:US
Practice Address - Phone:252-926-4379
Practice Address - Fax:252-926-3702
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered