Provider Demographics
NPI:1720741580
Name:WILLIAMS, KRISTI MARIE (RN)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:MARIE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 SWAMP RD
Mailing Address - Street 2:
Mailing Address - City:MONTAGUE
Mailing Address - State:MA
Mailing Address - Zip Code:01351-9528
Mailing Address - Country:US
Mailing Address - Phone:808-983-9035
Mailing Address - Fax:
Practice Address - Street 1:37 SWAMP RD
Practice Address - Street 2:
Practice Address - City:MONTAGUE
Practice Address - State:MA
Practice Address - Zip Code:01351-9528
Practice Address - Country:US
Practice Address - Phone:808-983-9035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT026.0142069163W00000X
MARN2347896163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse