Joseph Dominic Willis, ARNP
Nurse Practitioner in St Petersburg, FL. Individual provider (NPI-1).
NPI number1619082252
StatusActive
Last updated in NPPESFeb 13, 2017
Details
- NPI
- 1619082252
- Entity type
- Individual (NPI-1)
- Name
- Joseph Dominic Willis
- Credential
- ARNP
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 21, 2006
- Last updated
- Feb 13, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | ARNP1759342 | FL | Yes |
Practice location
10974 54th Ave NSt Petersburg, FL 33708-2943
Phone 727-579-4124
Mailing address
10974 54th Ave NSt Petersburg, FL 33708-2943
Phone 727-579-4124
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