CARLENE WILLIS FNP-C NPI 1740796358

NPI Information

NPI: 1740796358
Provider Name: CARLENE WILLIS, FNP-C
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: DESERT VALLEY MEDICAL GROUP INC

PECOS Registration: Yes

Address:
264 N HIGHLAND SPRINGS AVE STE 4
BANNING, CA
ZIP 92220
Phone: (951) 769-0079
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Carlene Willis, FNP-C is a family nurse practitioner in Banning, CA with 7 years of experience. Carlene Willis, FNP-C NPI is 1740796358. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

264 N HIGHLAND SPRINGS AVE STE 4
BANNING, CA
ZIP 92220-082
Phone: (951) 769-0079

The NPI 1740796358 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 12/19/2017 and was last updated on 12/19/2017.

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	95008027	CALIFORNIA	Yes

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: 11/14/2023

NPI Synchronization or Removal

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