Individual
MRS. KRISTINE S WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD LD
Contact information
Practice address
12000 STONE LAKE RD, DULCE HEALTH CENTER, DULCE, NM 87528
(505) 759-3291
(505) 759-7289
Mailing address
43 OPHIR DR, DURANGO, CO 81301
(970) 382-0927
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
468
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000K3526
—
NM
05
—
56186878
—
NM
01
—
HSZ196
MEDICARE PART B
NM
Enumeration date
02/27/2006
Last updated
06/03/2008
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