Basic Information
| Provider Information | |||||||||
| NPI: | 1700274016 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WILLIAMS-DAVIS | ||||||||
| FirstName: | CHRYSTAL | ||||||||
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| Credential: | FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 698 | ||||||||
| Address2: | |||||||||
| City: | BYHALIA | ||||||||
| State: | MS | ||||||||
| PostalCode: | 38611 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6628382163 | ||||||||
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| Practice Location | |||||||||
| Address1: | 12 E BRUNSWICK ST | ||||||||
| Address2: | |||||||||
| City: | BYHALIA | ||||||||
| State: | MS | ||||||||
| PostalCode: | 38611 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9017285858 | ||||||||
| FaxNumber: | 9015316312 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/08/2015 | ||||||||
| LastUpdateDate: | 02/19/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 19413 | TN | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | R872057 | MS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.