Marcelle Janice Willock

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F3085231 Issued in NY

Practice address

664 E 81St St
Brooklyn, NY 11236-3304

Phone

(917) 579-3575

NPI assigned

Nov 27, 2017

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)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1511740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1285148353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "664 E 81ST ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "664 E 81ST ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363304",
            "telephone_number": "917-579-3575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLOCK",
        "first_name": "MARCELLE",
        "middle_name": "JANICE",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-27",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F3085231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael L Willis, ADULT NURSE PRACTITI
• Samantha Willis
• Velta Willis, NP
• Marc Willner, PHARM.D.
• Rochel Willner
• Marsha Willock
• Willoughby Dental P.C.
• Willoughby Rehabilitation and Health Care Center LLC
• Marissa Ashley Willoughby-Naiditch, NP
• Willow Mental Health Services, LLC

• Adult Health Nurse Practitioner in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; 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.