Nishae Latrice Willis, CNA

Primary specialty

DriverTaxonomy code 172A00000X

License

V137105002 Issued in MO

Practice address

7315 Albright Ave
Saint Louis, MO 63136-1228

Phone

(314) 699-1166

NPI assigned

Jul 5, 2022

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

• Nishae Latrice Willis Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 5, 2022.

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1316670631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7315 ALBRIGHT AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631361228",
            "telephone_number": "314-699-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7315 ALBRIGHT AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631361228",
            "telephone_number": "314-699-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "NISHAE",
        "middle_name": "LATRICE",
        "credential": "CNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-05",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "MO",
            "license": "V137105002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Na",
            "affiliation": "N",
            "endpointDescription": "Na",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7315 Albright Ave",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631361228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "NA",
            "affiliation": "N",
            "endpointDescription": "NA",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7315 Albright Ave",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631361228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "NA",
            "affiliation": "N",
            "endpointDescription": "NA",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7315 Albright Ave",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631361228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NISHAE",
            "last_name": "WILLIS",
            "middle_name": "LATRICE",
            "credential": "CNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel Nathan Willis, MD
• Ericka Nycole Willis
• Hannah Marie Willis, PA
• Julie A Willis, PA-C
• Kristen Willis, AUD
• Patricia Ann Willis, ANP-BC
• Sara Willis
• Sophie Willis, PHARM.D.
• Susan E Willis, RN, BSN
• Zachary Willis, D.O.

• All providers in Saint Louis, MO
• Driver in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.