Angela Petrina Willliams, REGISTERED NURSE

Primary specialty

Infusion Therapy Registered NurseTaxonomy code 163WI0500X

License

RN9375368 Issued in FL

Practice address

1042 Milnor St
Jacksonville, FL 32206-5813

Phone

(904) 405-9884

NPI assigned

Oct 22, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 6

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": "1729555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1285455147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1042 MILNOR ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322065813",
            "telephone_number": "904-405-9884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1042 MILNOR ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322065813",
            "telephone_number": "904-405-9884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLLIAMS",
        "first_name": "ANGELA",
        "middle_name": "PETRINA",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-22",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9375368",
            "primary": false
        },
        {
            "code": "163WH1000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hospice",
            "state": "FL",
            "license": "RN9375368",
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "FL",
            "license": "RN9375368",
            "primary": false
        },
        {
            "code": "163WS0121X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Plastic Surgery",
            "state": "FL",
            "license": "RN9375368",
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "FL",
            "license": "RN9375368",
            "primary": false
        },
        {
            "code": "163WI0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "FL",
            "license": "RN9375368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Marie Willis
• Floyd Willis, MD
• Gina Willis, LMT
• Lakeisha Willis
• Nelson S Willis, LCSW
• Willows Tree Behavioral Health
• Gwendolyn Ong Wills, RPH
• Jordan Marie Wills
• Sofia Wills, MA
• Sarah Willson

• Infusion Therapy Registered Nurse in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Infusion Therapy Registered Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; 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.