Provider Demographics
NPI:1811546534
Name:WILLIAMS, JASMINE MARIE
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:MARIE
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 1:10631 NACOGDOCHES RD APT 701
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-2884
Mailing Address - Country:US
Mailing Address - Phone:210-771-5497
Mailing Address - Fax:
Practice Address - Street 1:10631 NACOGDOCHES RD APT 701
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-2884
Practice Address - Country:US
Practice Address - Phone:210-771-5497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion