Mrs La Juana Dell Willis, CFNP is a
Nurse Practitioner based in Logan, New Mexico. Mrs La Juana Dell Willis is licensed to practice in New Mexico (license number CNP00145) and her current practice location is
600 Gallegos, Logan, New Mexico. She can be reached at her office (for appointments etc.) via phone at
(575) 487-9000.
NPI number for Mrs La Juana Dell Willis is 1306952932 and her current mailing address is Po Box 26666, Phs Provider Enrollment, Albuquerque, New Mexico. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1306952932.
Provider's Profile
| Full Name | Mrs La Juana Dell Willis |
|---|
| Gender | Female |
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| Speciality | Nurse Practitioner |
|---|
| Location | 600 Gallegos, Logan, New Mexico |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1306952932
- Provider Enumeration Date: 08/23/2006
- Last Update Date: 10/21/2019
Medical Identifiers
Medical identifiers for Mrs La Juana Dell Willis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1306952932 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363L00000X | Nurse Practitioner | CNP00145 (New Mexico) | Primary |
| 363LF0000X | Nurse Practitioner - Family | R14626 (New Mexico) | Secondary |
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. Mrs La Juana Dell 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 |
|---|
Mrs La Juana Dell Willis, CFNP
Po Box 26666, Phs Provider Enrollment,
Albuquerque, NM 87125-6666
Ph: (505) 923-6770 | Mrs La Juana Dell Willis, CFNP
600 Gallegos,
Logan, NM 88426-7602
Ph: (575) 487-9000 |
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