Jessica Marie Willis

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN9380777 Issued in FL

Practice address

9823 W Seven Rivers Farm St
Crystal River, FL 34428-6805

Phone

(352) 464-1362

NPI assigned

Mar 23, 2022

Last updated

Mar 27, 2022By the provider in NPPES

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

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": "1647993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648339200000",
    "number": "1255081394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9823 W SEVEN RIVERS FARM ST",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344286805",
            "telephone_number": "352-464-1362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9823 W SEVEN RIVERS FARM ST",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344286805",
            "telephone_number": "352-464-1362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-23",
        "last_updated": "2022-03-27",
        "certification_date": "2022-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9380777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corey Wharton, RPT
• Shannon Holmes Whitehead
• Clifford Milton Wiggins, LMT
• Kayla Williams, APRN
• Sarah Williams
• Willow and Words Speech and Language Services, LLC
• Alexis Wilson, AUD
• Bethel McMullen Wilson
• Carlene A. Wilson, M.D.
• Paul Winstead, LMHC

• Registered Nurse in Crystal River, FL
• Providers in Crystal River, FL by specialty
• Registered Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2022; 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.