Healthcare Provider Details

I. General information

NPI: 1669814463
Provider Name (Legal Business Name): KRISTA MARIA WILLIAMS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2013
Last Update Date: 10/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 BRENNER AVE
SALISBURY NC
28144-2515
US

IV. Provider business mailing address

5225 NOBLE APT 204
CONCORD NC
28027-0073
US

V. Phone/Fax

Practice location:
  • Phone: 305-401-9171
  • Fax:
Mailing address:
  • Phone: 305-401-9171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberPST021390
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberR-17096
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberPSI28855
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberPS53380
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: