Provider Demographics
NPI:1124614052
Name:WILLIAMS, CHRISTINA ANN (NP-C)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:ANN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18370 AA HWY
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:65025-2028
Mailing Address - Country:US
Mailing Address - Phone:660-473-0946
Mailing Address - Fax:
Practice Address - Street 1:2305 S HIGHWAY 65 BLDG A
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MO
Practice Address - Zip Code:65340-3702
Practice Address - Country:US
Practice Address - Phone:660-886-7800
Practice Address - Fax:660-831-3328
Is Sole Proprietor?:No
Enumeration Date:2020-12-15
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020035542363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily