Healthcare Provider Details

I. General information

NPI: 1184336729
Provider Name (Legal Business Name): KRISTEN MARIE BURTON-WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2022
Last Update Date: 12/14/2022
Certification Date: 12/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

593 EDDY ST
PROVIDENCE RI
02903-4923
US

IV. Provider business mailing address

15 CAROLINA MAIN ST
RICHMOND RI
02812-1032
US

V. Phone/Fax

Practice location:
  • Phone: 401-444-2504
  • Fax:
Mailing address:
  • Phone: 401-261-7230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License NumberAPRN01579
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: