MEDICARE: CHRISTIANA E WILLIAMS MS, RD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1629658539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIANA E WILLIAMS MS, RD

Provider Business Mailing Address
First Line	:	PO BOX 173
Second Line	:
City	:	MARSHALLS CREEK
State	:	PA
Zip	:	18335-0173
Country	:	US
Telephone Number	:	610-425-0234
Fax Number	:

Provider Business Practice Location Address
First Line	:	202 CREEK RUN
Second Line	:
City	:	EAST STROUDSBURG
State	:	PA
Zip	:	18302-8548
Country	:	US
Telephone Number	:	610-425-0234
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2021
Last Update Date	:	04/13/2021

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