Provider Demographics
NPI:1700440732
Name:WILLIAMS, CESSALEE NELL (SA-C)
Entity Type:Individual
Prefix:
First Name:CESSALEE
Middle Name:NELL
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1905 E MCHENRY RD
Mailing Address - Street 2:
Mailing Address - City:PERKINSTON
Mailing Address - State:MS
Mailing Address - Zip Code:39573-3453
Mailing Address - Country:US
Mailing Address - Phone:601-528-2460
Mailing Address - Fax:
Practice Address - Street 1:1905 E MCHENRY RD
Practice Address - Street 2:
Practice Address - City:PERKINSTON
Practice Address - State:MS
Practice Address - Zip Code:39573-3453
Practice Address - Country:US
Practice Address - Phone:601-528-2460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-25
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant