Provider Demographics
NPI:1891221982
Name:WILLIAMS, JADE C
Entity Type:Individual
Prefix:
First Name:JADE
Middle Name:C
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 1:1915 CYPRESS CREEK RD
Mailing Address - Street 2:APT 232E
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70123-6207
Mailing Address - Country:US
Mailing Address - Phone:337-852-8463
Mailing Address - Fax:
Practice Address - Street 1:1915 CYPRESS CREEK RD
Practice Address - Street 2:APT 232E
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70123-6207
Practice Address - Country:US
Practice Address - Phone:337-852-8463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-10
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA150962163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse