Provider Demographics
NPI:1033811609
Name:WILLIAMS, SADRIEKA KELLESSIA (RN)
Entity Type:Individual
Prefix:
First Name:SADRIEKA
Middle Name:KELLESSIA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2476 OCEAN VIEW BLVD APT 201
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-4852
Mailing Address - Country:US
Mailing Address - Phone:260-710-9363
Mailing Address - Fax:
Practice Address - Street 1:2476 OCEAN VIEW BLVD APT 201
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-4852
Practice Address - Country:US
Practice Address - Phone:260-710-9363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9505860163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical