Provider Demographics
NPI:1871931097
Name:WILLIAMS, CHRISTINA ANGELEE (STNA)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:ANGELEE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1217 DAWSETT AVE
Mailing Address - Street 2:
Mailing Address - City:GALION
Mailing Address - State:OH
Mailing Address - Zip Code:44833-3316
Mailing Address - Country:US
Mailing Address - Phone:419-961-7753
Mailing Address - Fax:
Practice Address - Street 1:1217 DAWSETT AVE
Practice Address - Street 2:
Practice Address - City:GALION
Practice Address - State:OH
Practice Address - Zip Code:44833-3316
Practice Address - Country:US
Practice Address - Phone:419-961-7753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-10
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOHIO STNA374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide