Healthcare Provider Details

I. General information

NPI: 1073481081
Provider Name (Legal Business Name): KRIS WILLIAMSON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2025
Last Update Date: 12/14/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3054 US HIGHWAY 11 S
ATTALLA AL
35954-5801
US

IV. Provider business mailing address

3054 US HIGHWAY 11 S
ATTALLA AL
35954-5801
US

V. Phone/Fax

Practice location:
  • Phone: 256-622-3420
  • Fax:
Mailing address:
  • Phone: 256-622-3420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-169412
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number57811
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: