Provider Demographics
NPI:1154952976
Name:WILLIAMS, VANESSA G (OWNER)
Entity type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:G
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:OWNER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 S HOUMAS AVE
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-4916
Mailing Address - Country:US
Mailing Address - Phone:225-390-6320
Mailing Address - Fax:225-644-5225
Practice Address - Street 1:1624 S HOUMAS AVE
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-4916
Practice Address - Country:US
Practice Address - Phone:225-390-6320
Practice Address - Fax:225-644-5225
Is Sole Proprietor?:No
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker