Nancy Willis, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

019263 Issued in NC

Practice address

200 Hawthorne Lane
Charlotte, NC 28204

Phone

(704) 384-4239

Fax

(704) 384-5636

NPI assigned

May 11, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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 and National Provider Directory roles.

• The Presbyterian Hospital

  • Certified Registered Nurse Anesthetist
  • Charlotte, NC
  • NPI 1487626933

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187568000000",
    "number": "1245280197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601549",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601549",
            "telephone_number": "704-384-4239",
            "fax_number": "704-384-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWTHORNE LANE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28204",
            "telephone_number": "704-384-4239",
            "fax_number": "704-384-5636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "NANCY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2007-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "019263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NAN076",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8050845",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aleya Karenton Willis
• Danielle C Willis, LCSWA
• Jason Alexander Willis, PA
• Jazmine Alyssia Willis
• Katherine Willis
• Nancy Ausbon Willis, LCAS, CCS
• Robert Grant Willis, M.D.
• Larissa Paige Willner, PT, DPT
• Willor Enterprises LLC
• Ayanna M Willoughby

• Certified Registered Nurse Anesthetist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Certified Registered Nurse Anesthetist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.