MELODY KAY WILLIS


Address: 1857 Rue Lamande, Bonne Terre, MO 63628-9206
Phone: 5733002690

MELODY KAY WILLIS (NPI# 1336604370) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1336604370
Entity Type Individual
Full Name MELODY KAY WILLIS
Credential MSN, RN, PMHNP-BC
Practice Address 1857 Rue Lamande
Bonne Terre
MO 63628-9206
Practice Telephone 5733002690
Mailing Telephone 5733002690
Enumeration Date 2019-02-04
Last Update Date 2019-02-04
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
2018089610 MO Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 1857 RUE LAMANDE
City BONNE TERRE
State MO
Zip Code 63628-9206

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Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

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Competitor

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City BONNE TERRE
Zip Code 63628

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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