ANGELA G WILLOCKS NP NPI 1033177092

NPI Information

NPI: 1033177092
Provider Name: ANGELA G WILLOCKS, NP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
325 N STATE OF FRANKLIN RD
GROUND FLOOR
JOHNSON CITY, TN
ZIP 37604
Phone: (423) 439-7320
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Angela G Willocks, NP is a family nurse practitioner in Johnson City, TN with 25 years of experience. Angela G Willocks, NP NPI is 1033177092. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: EAST TENNESSEE STATE UNIVERSITY QUILLEN COLLEGE OF MEDICINE
Graduation Year:1999

The provider's business location address is:

325 N STATE OF FRANKLIN RD
GROUND FLOOR
JOHNSON CITY, TN
ZIP 37604-062
Phone: (423) 439-7320
Fax: (423) 439-7343

The NPI 1033177092 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/1/2006 and was last updated on 1/29/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	7097	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1509062	MEDICAID	TENNESSEE
2	03/30/1972	OTHER		DATE OF BIRTH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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