Provider Demographics
NPI:1255568671
Name:WARDRICK-WILLIAMS, SANDRA JEANNINE
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:JEANNINE
Last Name:WARDRICK-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 1:435 ALBANY ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-6387
Mailing Address - Country:US
Mailing Address - Phone:540-786-1829
Mailing Address - Fax:540-786-1829
Practice Address - Street 1:435 ALBANY ST
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-6387
Practice Address - Country:US
Practice Address - Phone:540-786-1829
Practice Address - Fax:540-786-1829
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-11
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant