Provider Demographics
NPI:1235595224
Name:WILLIAMS, KRISTIN COOPER (IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:COOPER
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 AILOR AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37921-5804
Mailing Address - Country:US
Mailing Address - Phone:865-524-4422
Mailing Address - Fax:
Practice Address - Street 1:1925 AILOR AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37921-5804
Practice Address - Country:US
Practice Address - Phone:865-524-4422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-07
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11128043174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN