Provider Demographics
NPI:1972027522
Name:WILLIAMS, KRISTEN PETERMAN (CRNP)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:PETERMAN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 WOODLEY AVE
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:AL
Mailing Address - Zip Code:36081-4536
Mailing Address - Country:US
Mailing Address - Phone:334-805-4211
Mailing Address - Fax:
Practice Address - Street 1:801 S FRANKLIN DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:AL
Practice Address - Zip Code:36081-3838
Practice Address - Country:US
Practice Address - Phone:334-566-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-26
Last Update Date:2017-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-138859363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily