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Contact Information

SUZIE L WILLIS, APRN
8380 RIVERWALK PARK BLVD
SUITE 100
FORT MYERS, FL33919-8758
 Phone: 239-343-9960
 Fax: 239-343-9977
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Medical-Surgical

364SM0705X 89 Certified Clinical Nurse Specialist
Indicates primary specialty

NPI Profile & details for SUZIE L WILLIS · (Female)

NPI # 1639612492
Status Active
Credentials APRN (Advanced Practice Registered Nurse)
Entity Individual
Enumeration date 11/28/2016
Last updated 11/10/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • FL License # APRN3290832
  • FL Medicaid 020396200
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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