Provider Demographics
NPI:1801875158
Name:WILLIAMS, JESSICA A
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:A
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 1:516 S DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-2382
Mailing Address - Country:US
Mailing Address - Phone:319-277-3105
Mailing Address - Fax:319-277-8019
Practice Address - Street 1:309 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:MARSHALLTOWN
Practice Address - State:IA
Practice Address - Zip Code:50158-2946
Practice Address - Country:US
Practice Address - Phone:641-754-6200
Practice Address - Fax:641-754-6245
Is Sole Proprietor?:No
Enumeration Date:2006-01-14
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00800237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0423756Medicaid
IAI11252Medicare PIN