Courtney Marie Willis

Primary specialty

Infectious Diseases PharmacistTaxonomy code 1835I0206X

License

PS53352 Issued in FL

Practice address

4500 San Pablo Rd S
Jacksonville, FL 32224-1865

Phone

(904) 953-2000

NPI assigned

Jun 3, 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

Other names 1

• Courtney Marie Willis Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1748908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1104719459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14042 SADDLEHILL CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585515",
            "telephone_number": "407-920-1568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "904-953-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "COURTNEY",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-03",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835I0206X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Infectious Diseases",
            "state": "FL",
            "license": "PS53352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "WILLIS",
            "middle_name": "MARIE",
            "credential": "PHARMACIST",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Willie & Essie Angels of Heaven LLC
• Emonie Denise Willie
• Darrin Lamar Willingham, M.D.
• Lee Willingham
• Arlease Willis
• Floyd Willis, MD
• Gina Willis, LMT
• Lakeisha Willis
• Nelson S Willis, LCSW
• Angela Petrina Willliams, REGISTERED NURSE

• Infectious Diseases Pharmacist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Infectious Diseases Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2025; 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.