Provider Demographics
NPI:1982423968
Name:WILLIAMS-PARKS, KRISTINA A
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:A
Last Name:WILLIAMS-PARKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3360 E LIVINGSTON AVE STE 3B1
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43227-1925
Mailing Address - Country:US
Mailing Address - Phone:614-432-2397
Mailing Address - Fax:
Practice Address - Street 1:3360 E LIVINGSTON AVE STE 3B1
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43227-1925
Practice Address - Country:US
Practice Address - Phone:614-432-2397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2099HHN251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health