Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | ARNP9202896 | FL |
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | APRN9202896 | FL |
NPI | 1013272228 |
---|---|
Provider Name | Willine Louis |
First Address | Boca Raton, FL 33431 |
Second Address | Boca Raton, FL 33431 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2012 |
Last Update Date | 09/02/2022 |