Jesse Willard, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

320697-31 Issued in WI

Practice address

1128 Morraine View Dr
Unit 301
Madison, WI 53719-3078

Phone

(608) 338-9774

NPI assigned

Sep 18, 2016

Last updated

Sep 18, 2016By the provider in NPPES

Sex

Male

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

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": "1474156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474156800000",
    "number": "1114475225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1128 MORRAINE VIEW DR",
            "address_2": "UNIT 301",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537193078",
            "telephone_number": "608-338-9774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1128 MORRAINE VIEW DR",
            "address_2": "UNIT 301",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537193078",
            "telephone_number": "608-338-9774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLARD",
        "first_name": "JESSE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-18",
        "last_updated": "2016-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "320697-31",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mitchell J. Wilkins, CRNA
• Kathleen L Wilkinson, PA
• Laura Wilkinson, LCSW
• Tyler D Will, M.D.
• Jessica Willadsen
• Christa Mattson Wille, DPT
• Audrey Willems Van Dijk, RN
• Katie Lynn Willenborg
• Matthew J Willenborg
• Jamie Willes, RBT

• Licensed Practical Nurse in Madison, WI
• Providers in Madison, WI by specialty
• Licensed Practical Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2016; 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.