Melania J Willis, ARNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

2734962 Issued in FL

Practice address

701 Ohio Ave S
Live Oak, FL 32064-3816

Phone

(386) 330-5248

Fax

(386) 208-1380

NPI assigned

Aug 9, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fidelity Medical Services PLC Dba Mid-Town Center for Health

  dba Mid-Town Center For Health

  • Family Medicine Physician
  • Live Oak, FL
  • NPI 1326196924
  NPD (past)
• Physicians Group Services PA

  dba Coastal Health

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1679737308

  Pediatrics

  NPD (past)
• Physicians Group Services PA

  dba Coastal Health

  • Durable Medical Equipment & Medical Supplies
  • Middleburg, FL
  • NPI 1699170035
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013927995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 S COUNTY ROAD 125",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320635328",
            "telephone_number": "904-259-9257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 OHIO AVE S",
            "city": "LIVE OAK",
            "state": "FL",
            "postal_code": "320643816",
            "telephone_number": "386-330-5248",
            "fax_number": "386-208-1380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "MELANIA",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "2734962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Waybrant-Ennis, APRN, DNP, PMHNP-BC
• Penny Ann West, APRN
• Demaycia Jemirea Wheeler
• Teri Lynn Wilhoite, LMT
• Kristin N Williams
• Aymee Wilson, ARNP
• Michael Wayne Wood, D.C.
• John A Workman, DC
• Gloria Wu, PA-C
• Amanda Nicole Zajchowski, APRN

• Pediatric Nurse Practitioner in Live Oak, FL
• Providers in Live Oak, FL by specialty
• Pediatric Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.