Willis, Danine Theresa

Willis, Danine Theresa is an individual health care provider with primary practice located at 2216 E 32Nd St Ste 101 , Joplin MO 64804-3015. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Willis, Danine Theresa can be contacted via phone (417) 556-2780.

Contact Information

Primary practice address
2216 E 32Nd St Ste 101 Joplin MO 64804-3015
Phone: (417) 556-2780
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 44929 Kansas
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X A004899 Arkansas
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 2004033676 Missouri

Profile Details

NPI number 1710953559
LBN Legal business name Willis, Danine Theresa
Credentials A.R.N.P.
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 23rd, 2006
Last updated Jun 5th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710953559 NPPES
Kansas MEDICAID 100352890C

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