Amelia Willis, CPNP-PC | |
23 Sunnybrook Rd, Raleigh, NC 27610-1855 | |
(919) 250-3478 | |
Not Available |
Full Name | Amelia Willis |
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Gender | Female |
Speciality | Nurse Practitioner - Pediatrics |
Location | 23 Sunnybrook Rd, Raleigh, North Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1679129720 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LP0200X | Nurse Practitioner - Pediatrics | 283152 (North Carolina) | Secondary |
363LP0200X | Nurse Practitioner - Pediatrics | 1012636 (Texas) | Primary |
Entity Name | Longhorn Emergency Medical Associates Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1649669672 PECOS PAC ID: 4486971041 Enrollment ID: O20150320000152 |
Mailing Address | Practice Location Address |
---|---|
Amelia Willis, CPNP-PC 23 Sunnybrook Rd, Raleigh, NC 27610-1855 Ph: (919) 250-3478 | Amelia Willis, CPNP-PC 23 Sunnybrook Rd, Raleigh, NC 27610-1855 Ph: (919) 250-3478 |
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