MEDICARE: MACKENZIE DENISE CEASAR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	372600000X	Adult Companion
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1699234575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MACKENZIE DENISE CEASAR

Provider Business Mailing Address
First Line	:	1533 FOURTH ST
Second Line	:
City	:	JONESVILLE
State	:	LA
Zip	:	71343-2127
Country	:	US
Telephone Number	:	318-339-7752
Fax Number	:	318-339-7753

Provider Business Practice Location Address
First Line	:	2803 FOURTH ST
Second Line	:
City	:	JONESVILLE
State	:	LA
Zip	:	71343-2004
Country	:	US
Telephone Number	:	318-240-3779
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2019
Last Update Date	:	09/30/2024

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Directions to “ MACKENZIE DENISE CEASAR ” Practice Location

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