Provider Demographics
NPI:1043992688
Name:WILLIAMS, SUDDIE
Entity Type:Individual
Prefix:
First Name:SUDDIE
Middle Name:
Last Name:WILLIAMS
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 1:2814 ERIE ST SE APT C44
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-3125
Mailing Address - Country:US
Mailing Address - Phone:202-714-0744
Mailing Address - Fax:
Practice Address - Street 1:2810 ERIE ST SE APT A26
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-3123
Practice Address - Country:US
Practice Address - Phone:202-674-0007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant