Paula Marie Willis, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

P15908 Issued in SC

Practice address

651 Grays Hwy
Ridgeland, SC 29936-5488

Phone

(843) 726-7788

Fax

(843) 726-5320

NPI assigned

Sep 26, 2016

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": "1474848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474848000000",
    "number": "1609325166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3516 GRAYS HWY",
            "city": "RIDGELAND",
            "state": "SC",
            "postal_code": "299364419",
            "telephone_number": "843-726-7788",
            "fax_number": "843-726-5320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 GRAYS HWY",
            "city": "RIDGELAND",
            "state": "SC",
            "postal_code": "299365488",
            "telephone_number": "843-726-7788",
            "fax_number": "843-726-5320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "PAULA",
        "middle_name": "MARIE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-26",
        "last_updated": "2016-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "SC",
            "license": "P15908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Chinnici Wells, DC
• Lora Ann Welter, R.D., L.D.
• Bettie West, MA
• Peter Francis White, M.D.
• Joyce Lorraine Willis
• Wooster Dental Care PC
• Wooster Dental LLC
• Jay Scott Wooster, DDS
• Marc Wooster, D.M.D.
• Wright Directions, LLC

• Licensed Practical Nurse in Ridgeland, SC
• Providers in Ridgeland, SC by specialty
• Licensed Practical Nurse in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2016; 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.