Individual provider · Type 1 NPI
Elizabeth Adrienne Willis, RN, MS, PMHNP-BC
Psychiatric/Mental Health Nurse Practitioner · Cloverdale, CA
NPI number
1104536549
Active
Practice location
6 Tarman Dr
Cloverdale, CA 95425-3932
Mailing address
PO Box 253
Sebastopol, CA 95473-0253
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Emergency Registered Nurse | 163WE0003X | 793320 (CA) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 95017303 (CA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1104536549
Elizabeth Adrienne Willis, RN, MS, PMHNP-BC's National Provider Identifier is 1104536549, issued on Nov 28, 2022. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Cloverdale, CA. The record was last updated on Nov 28, 2022.