Willis, Suzie L

Willis, Suzie L is an individual health care provider with primary practice located at 8380 Riverwalk Park Blvd Suite 100, Fort Myers FL 33919-8758. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical-Surgical, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Willis, Suzie L can be contacted via phone (239) 343-9960.

Contact Information

Primary practice address
8380 Riverwalk Park Blvd Suite 100 Fort Myers FL 33919-8758
Phone: (239) 343-9960
Fax: (239) 343-9977
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical-Surgical 364SM0705X APRN3290832 Florida
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APRN3290832 Florida

Profile Details

NPI number 1639612492
LBN Legal business name Willis, Suzie L
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 28th, 2016
Last updated Nov 10th, 2021 - about 3 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 1639612492 NPPES
Florida MEDICAID 020396200

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