Dusty Mahealani Willis, LPN is a
Licensed Practical Nurse based in Boulder City, Nevada. Dusty Mahealani Willis is licensed to practice in Nevada (license number 835700) and her current practice location is
100 Veterans Memorial Dr, Boulder City, Nevada. She can be reached at her office (for appointments etc.) via phone at
(702) 332-6784.
NPI number for Dusty Mahealani Willis is 1780322644 and her current mailing address is 177 Vitale Ave, Henderson, Nevada. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1780322644.
Provider's Profile
| Full Name | Dusty Mahealani Willis |
|---|
| Gender | Female |
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| Speciality | Licensed Practical Nurse |
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| Location | 100 Veterans Memorial Dr, Boulder City, Nevada |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1780322644
- Provider Enumeration Date: 05/21/2022
- Last Update Date: 05/21/2022
Medical Identifiers
Medical identifiers for Dusty Mahealani Willis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1780322644 | NPI | - | NPPES |
| LPN-10376 | Other | HI | HAWAII BOARD OF NURSING - PVL |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 164W00000X | Licensed Practical Nurse | 835700 (Nevada) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dusty Mahealani Willis is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dusty Mahealani Willis, LPN
177 Vitale Ave,
Henderson, NV 89002-9208
Ph: (808) 387-4705 | Dusty Mahealani Willis, LPN
100 Veterans Memorial Dr,
Boulder City, NV 89005-1926
Ph: (702) 332-6784 |
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