MR. WILLIS SMITH APRN NPI 1861882847

NPI Information

  • NPI: 1861882847
  • Provider Name: MR. WILLIS SMITH, APRN
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 751 LOMBARDI CT
    SANTA ROSA, CA
    ZIP 95407
  • Phone: (707) 303-6000

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NPI Details

MR. Willis Smith, APRN is a psychiatric/mental health nurse practitioner in Santa Rosa, CA with 6 years of experience. MR. Willis Smith, APRN NPI is 1861882847. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: VANDERBILT UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2020

The provider's business location address is:

751 LOMBARDI CT
SANTA ROSA, CA
ZIP 95407-798
Phone: (707) 303-6000

The NPI 1861882847 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 1/29/2015 and was last updated on 2/2/2024.

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
1363LP0808XNurse PractitionerPsychiatric/Mental Health28278TENNESSEENo
2363LP0808XNurse PractitionerPsychiatric/Mental Health95017534CALIFORNIAYes
3101YP2500XCounselorProfessionalP1701203ARKANSASNo

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: 11/21/2025

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