MRS. JENNIFER TRICIA WILLIS (NPI# 1427043983) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427043983 |
| Entity Type | Individual |
| Full Name | MRS. JENNIFER TRICIA WILLIS |
| Other Name | MISS JENNIFER TRICIA BROLO |
| Credential | CRNA |
| Practice Address |
2608 Crest Valley Drive Conyers GA 30094 |
| Practice Telephone | 4044282237 |
| Practice Fax Number | 4044282237 |
| Mailing Telephone | 7706488237 |
| Mailing Fax Number | 7706488237 |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2015-12-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 180459 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659766970 | Jennifer Cena Willis | Registered Nurse | 6389 Marbella Ln, Eastvale, CA 91752-7313 | 2015-04-02 |
| 1023368081 | Jennifer Ray Willis | Social Worker | 700 Lampton Ln, Mcalester, OK 74501-7028 | 2012-09-17 |
| 1124306543 | Jennifer Willis | Contractor | 6060 N Central Expy Ste 500, Dallas, TX 75206-5209 | 2011-08-02 |
| 1104864255 | Jennifer Beth Willis | Social Worker | 2103 Golf Course Road Se, Suite A, Rio Rancho, NM 87124-2071 | 2006-06-02 |
| 1841815453 | Jennifer Willis | Pharmacist | 2400 Mountain Dr Ste 104, Hoover, AL 35226-1569 | 2020-06-09 |
| 1982249199 | Jennifer Willis | Massage Therapist | 5 Morgan Hwy Ste 4, Scranton, PA 18508-2641 | 2019-11-12 |
| 1598268724 | Jennifer Stewart Willis | Counselor | 3840 Hulen St, Fort Worth, TX 76107-7277 | 2018-03-14 |
| 1356859847 | Jennifer Willis | Counselor | 3100 Euclid Ave, Cleveland, OH 44115-2508 | 2018-01-18 |
| 1831578277 | Jennifer Willis | Physical Therapy Assistant | 1 Donham Plz Fl 4, Middletown, OH 45042-1932 | 2015-05-19 |
| 1740671205 | Jennifer Willis | Registered Nurse | 424 Savannah Rd, Lewes, DE 19958-1462 | 2015-02-05 |
| Street Address |
2608 CREST VALLEY DRIVE |
| City | CONYERS |
| State | GA |
| Zip Code | 30094 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164029054 | Darlene Fletcher | Counselor | 827 St. Clair Dr., Conyers, GA 30094 | 2020-10-05 |
| 1194363366 | Clara A Matthews | Physician Assistant | 1930 Windsor Creek Drive Sw, Conyers, GA 30094 | 2019-12-18 |
| 1659838571 | Sensitive Home Care Agency Inc. | PACE Provider Organization | 2225 Morning Dew, Conyers, GA 30094 | 2019-02-27 |
| 1679097992 | Sheira Dennis | Case Management | 3828 Martingale Dr Se, Conyers, GA 30094 | 2017-07-28 |
| 1730571399 | Wellness and Trauma Recovery Center | Counselor | 1775 Parker Rd. Building C, Suite 210, Conyers, GA 30094 | 2015-02-19 |
| 1760870612 | Michael Terrell | Technician/Technologist | 806 Cambridge Creek Dr, Conyers, GA 30094 | 2014-12-30 |
| 1538567466 | Jennifer Angela Johnson | Registered Nurse | 2240 Wren Rd Se, Conyers, GA 30094 | 2014-12-09 |
| 1225445208 | Wanda Marcella Rainey-reed | Counselor | 1453 Klondike Rd Sw Ste D, Conyers, GA 30094 | 2014-07-22 |
| 1508155268 | Nicklaus Trent Rice | Obstetrics & Gynecology | 2750 Owens Dr, Conyers, GA 30094 | 2011-04-04 |
| 1720219660 | Candace Alexander | Dentist | 863 Flat Shoals Rd Se, Suite C #220, Conyers, GA 30094 | 2009-07-27 |
| Find all providers in zip 30094 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164795993 | Lisa R. Johnson | Nurse Anesthetist, Certified Registered | 2053 Reflection Creek Dr, Conyers, GA 30013-7423 | 2012-02-09 |
| 1871525428 | Brenda D. Buchanan | Nurse Anesthetist, Certified Registered | 1388 Wellbrook Circle, A, Conyers, GA 30012-3872 | 2006-07-06 |
| 1851344089 | Patricia Lynn Brunton | Nurse Anesthetist, Certified Registered | 3691 Sandhill Dr Se, Conyers, GA 30094-3733 | 2006-05-18 |
| 1053735548 | Regina Greenfield | Nurse Anesthetist, Certified Registered | 1359 Milstead Rd Ne, Suite 103, Conyers, GA 30012-3865 | 2014-02-05 |
| 1548532898 | Cristy Y Burkle | Nurse Anesthetist, Certified Registered | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2012-02-02 |
| 1144398488 | Tabitha Beverly | Nurse Anesthetist, Certified Registered | 1388b Wellbrook Cir Ne, Conyers, GA 30012-3872 | 2006-12-04 |
| 1013084136 | Marcia E Steinberg | Nurse Anesthetist, Certified Registered | 1388 Wellbrook Cir Ne, Conyers, GA 30012-3872 | 2006-11-30 |
| 1194790907 | Veronica Chambliss | Nurse Anesthetist, Certified Registered | 1388b Wellbrook Cir Ne, Conyers, GA 30012-3872 | 2006-02-23 |
| 1396710844 | Talitha Bonner | Nurse Anesthetist, Certified Registered | 1388b Wellbrook Cir Ne, Conyers, GA 30012-3872 | 2006-02-20 |
| 1144294828 | Cecilia Morales | Nurse Anesthetist, Certified Registered | 1388b Wellbrook Cir Ne, Conyers, GA 30012-3872 | 2006-02-17 |
| Find all providers in CONYERS | ||||
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| 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.