Provider Demographics
NPI:1699234575
Name:CEASAR, MACKENZIE DENISE
Entity type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:DENISE
Last Name:CEASAR
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 1:1533 FOURTH ST
Mailing Address - Street 2:
Mailing Address - City:JONESVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71343-2127
Mailing Address - Country:US
Mailing Address - Phone:318-339-7752
Mailing Address - Fax:318-339-7753
Practice Address - Street 1:2803 FOURTH ST
Practice Address - Street 2:
Practice Address - City:JONESVILLE
Practice Address - State:LA
Practice Address - Zip Code:71343-2004
Practice Address - Country:US
Practice Address - Phone:318-240-3779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-19
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty