Healthcare Provider Details

I. General information

NPI: 1710593041
Provider Name (Legal Business Name): KRISTEN MICHELLE WILLIAMS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTEN DINOFRIO

II. Dates (important events)

Enumeration Date: 09/22/2020
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 MARTHA JEFFERSON DR STE 315A
CHARLOTTESVILLE VA
22911-4668
US

IV. Provider business mailing address

320 E NORTH AVE
PITTSBURGH PA
15212-4756
US

V. Phone/Fax

Practice location:
  • Phone: 434-654-8390
  • Fax:
Mailing address:
  • Phone: 412-359-3030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA065305
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: