Provider Demographics
NPI:1255224903
Name:WILLIAMS, CRYSTAL DENISE
Entity type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:DENISE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:CRYSTAL
Other - Middle Name:DENISE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:440 CALHOUN RD
Mailing Address - Street 2:
Mailing Address - City:ST MATTHEWS
Mailing Address - State:SC
Mailing Address - Zip Code:29135-8266
Mailing Address - Country:US
Mailing Address - Phone:803-456-2282
Mailing Address - Fax:
Practice Address - Street 1:440 CALHOUN RD
Practice Address - Street 2:
Practice Address - City:ST MATTHEWS
Practice Address - State:SC
Practice Address - Zip Code:29135-8266
Practice Address - Country:US
Practice Address - Phone:803-456-2282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC266438163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse