Angelique Willis, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN11042009 Issued in FL

Practice address

217 Ashbrook St
Saint Augustine, FL 32084-0086

Phone

(904) 599-9192

NPI assigned

Sep 13, 2025

Sex

Female

Sole proprietor

Yes

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

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

• Ivx Health of Florida, P.a.

  • Infusion Therapy Clinic/Center
  • Altamonte Springs, FL
  • NPI 1821622432
  Medicare reassignment NPD

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

{
    "created_epoch": "1757721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757721600000",
    "number": "1053282129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 ASHBROOK ST",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320840086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 ASHBROOK ST",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320840086",
            "telephone_number": "904-599-9192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "ANGELIQUE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-13",
        "last_updated": "2025-09-13",
        "certification_date": "2025-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11042009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stanley Allen Williams, LMFT
• Trinity Williams, PHARM.D
• Victoria Williams
• Latascha Williamson
• Williemae Mind & Body Inc Dba Stretchlab First Coast
• Bryant Wilson, MD
• Jennifer Leighs Wilson, PHD, LCSW
• Kristen Lynn Wilson, DNP, CRNA
• Mary Kate Wilson, MD
• Rebecca Wilson

• Nurse Practitioner in Saint Augustine, FL
• Providers in Saint Augustine, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.