Willis, Susan M.

Willis, Susan M. is an individual health care provider with primary practice located at 7205 Lake Mead Blvd , Arlington TX 76016-4137. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Willis, Susan M. can be contacted via phone (817) 563-9211.

Contact Information

Primary practice address
7205 Lake Mead Blvd Arlington TX 76016-4137
Phone: (817) 563-9211
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 542468 Texas
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X AP101864 Texas

Profile Details

NPI number 1619975448
LBN Legal business name Willis, Susan M.
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2005
Last updated Dec 9th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619975448 NPPES
Texas MEDICAID 126080404
Texas Other 89479C

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