Provider Demographics
NPI:1104547793
Name:WILLIAMSON, KRISTEN ANNE (RD, LDN)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:ANNE
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:MISS
Other - First Name:KRISTEN
Other - Middle Name:ANNE
Other - Last Name:MCKINLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1703 16TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201-6001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1604 1ST ST S
Practice Address - Street 2:
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-4243
Practice Address - Country:US
Practice Address - Phone:320-240-2828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3666133VN1201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management