Crystal Willis, LPN is a
Licensed Practical Nurse based in Rockford, Tennessee. Crystal Willis is licensed to practice in Tennessee (license number LPN0000082566) and her current practice location is
253 Roddy Branch Rd, Rockford, Tennessee. She can be reached at her office (for appointments etc.) via phone at
(865) 617-5654.
NPI number for Crystal Willis is 1568813830 and her current mailing address is 253 Roddy Branch Rd, Rockford, Tennessee. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1568813830.
Provider's Profile
Full Name | Crystal Willis |
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Gender | Female |
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Speciality | Licensed Practical Nurse |
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Location | 253 Roddy Branch Rd, Rockford, Tennessee |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1568813830
- Provider Enumeration Date: 06/28/2016
- Last Update Date: 06/28/2016
Medical Identifiers
Medical identifiers for Crystal Willis such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1568813830 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
164W00000X | Licensed Practical Nurse | LPN0000082566 (Tennessee) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Crystal Willis is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Crystal Willis, LPN 253 Roddy Branch Rd, Rockford, TN 37853-3108 Ph: (865) 617-5654 | Crystal Willis, LPN 253 Roddy Branch Rd, Rockford, TN 37853-3108 Ph: (865) 617-5654 |
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