| Carlene Willis, FNP-C | |
|
264 N Highland Springs Ave Ste 4, Banning, CA 92220-3082 | |
| (951) 769-0079 | |
| Not Available |
| Full Name | Carlene Willis |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 9 Years |
| Location | 264 N Highland Springs Ave Ste 4, Banning, California |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740796358 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 95008027 (California) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Loma Linda University Medical Center | Loma linda, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Faculty Physicians And Surgeons Of Llusm | 1153227814 | 1153 |
| Entity Name | Faculty Physicians And Surgeons Of Llusm |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205009917 PECOS PAC ID: 1153227814 Enrollment ID: O20031211000981 |
| Entity Name | Desert Valley Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639117864 PECOS PAC ID: 4880595875 Enrollment ID: O20040113000803 |
| Entity Name | Southern California Emergency Medicine |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639314255 PECOS PAC ID: 8628128196 Enrollment ID: O20090604000499 |
| Mailing Address | Practice Location Address |
|---|---|
| Carlene Willis, FNP-C 264 N Highland Springs Ave Ste 4, Banning, CA 92220-3082 Ph: () - | Carlene Willis, FNP-C 264 N Highland Springs Ave Ste 4, Banning, CA 92220-3082 Ph: (951) 769-0079 |
Mrs. Marie Antoinette Tanare Lucco, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 264 N Highland Springs Ave, Banning, CA 92220 Phone: 760-413-3755 | |
Kevin Simmons, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 264 N Highland Springs Ave Ste 1b, Banning, CA 92220 Phone: 951-769-7191 | |
Amy Barber, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 161 W Ramsey St Bldg 2, Banning, CA 92220 Phone: 760-202-0686 | |
Monemala Philavong-danh, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 330 W Ramsey St, Banning, CA 92220 Phone: 951-849-1950 | |
Laura A Macmanus, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 264 N Highland Springs Ave, Banning, CA 92220 Phone: 951-845-6993 | |
Susan Jane Sheedy, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5957 W Ramsey St, Banning, CA 92220 Phone: 951-846-0313 | |
Kelly Marie Stormes, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6109 W Ramsey St, Banning, CA 92220 Phone: 951-845-0313 |