Provider Demographics
NPI:1417593120
Name:WILLIAMS, CHRISTINA JACKSON (WHNP-BC)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:JACKSON
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:856 J CLYDE MORRIS BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1318
Mailing Address - Country:US
Mailing Address - Phone:757-316-5800
Mailing Address - Fax:
Practice Address - Street 1:2855 DENBIGH BLVD STE B
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:VA
Practice Address - Zip Code:23692-6501
Practice Address - Country:US
Practice Address - Phone:757-750-2400
Practice Address - Fax:757-243-8382
Is Sole Proprietor?:No
Enumeration Date:2019-11-18
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024180460363LW0102X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC276885OtherNC BON