Samantha Willis
Registered Nurse in Brooklyn, NY. Individual provider (NPI-1).
NPI number1164055331
StatusActive
Last updated in NPPESFeb 17, 2020
Details
- NPI
- 1164055331
- Entity type
- Individual (NPI-1)
- Name
- Samantha Willis
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 17, 2020
- Certification date
- Feb 17, 2020
- Last updated
- Feb 17, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163W00000X | Registered Nurse | 696962 | NY | Yes |
Practice location
1366 E 102nd StBrooklyn, NY 11236-5312
Phone 347-446-3981
Mailing address
1366 E 102nd StBrooklyn, NY 11236-5312
Phone 347-446-3981
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