Provider Demographics
NPI:1851835888
Name:PRESLEY, WANDA SECTHECIA (CNA)
Entity Type:Individual
Prefix:MS
First Name:WANDA
Middle Name:SECTHECIA
Last Name:PRESLEY
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5809 WEST RICE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60651
Mailing Address - Country:US
Mailing Address - Phone:773-567-4878
Mailing Address - Fax:
Practice Address - Street 1:1140 SOUTH LAKE STREET
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301
Practice Address - Country:US
Practice Address - Phone:773-567-4878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-09
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide