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General NPI Number Information
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NPI Number | 1972357911
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Entity Type | Individual
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Provider Name | JESSICA SUE WILLIAMS
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Gender | Female
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Dates
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Enumeration Date | 04/16/2024
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Last Update Date | 04/16/2024
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Provider Practice Location Address
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Address Line | 2596 1/2 GRATIOT RD SE
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City | NEWARK
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State | OH
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Zip | 43056-9314
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Country | US
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Telephone | 740-763-3552
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Fax |
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Provider Business Mailing Address
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Address Line | 33 DAUGHERTY CIR
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City | NEWARK
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State | OH
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Zip | 43055-5276
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Country | US
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Telephone | 740-899-0307
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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