WILLARD MARVIN ANDERSON III (NPI# 1063756211) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063756211 |
| Entity Type | Individual |
| Full Name | WILLARD MARVIN ANDERSON III |
| Credential | PMHNP |
| Practice Address |
3686 Us Highway 331 S Defuniak Springs FL 32435-8463 |
| Practice Telephone | 8508928045 |
| Mailing Telephone | 8508928045 |
| Enumeration Date | 2012-11-11 |
| Last Update Date | 2012-11-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
9348879 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3686 US HIGHWAY 331 S |
| City | DEFUNIAK SPRINGS |
| State | FL |
| Zip Code | 32435-8463 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730174384 | Vida L Brinson | Counselor | 3686 Us Highway 331 S, Defuniak Springs, FL 32435-8463 | 2005-09-20 |
| 1548786379 | Joann Mccullough Culpepper | Social Worker | 3686 Us Highway 331 S, Defuniak Springs, FL 32435-8463 | 2017-08-14 |
| 1154843670 | Katie Weeks | Social Worker | 3686 Us Highway 331 S, Defuniak Springs, FL 32435-8463 | 2017-07-17 |
| 1508308495 | Lakeisha Parrish | Case Management | 3686 Us Highway 331 S, Defuniak Springs, FL 32435-8463 | 2016-11-09 |
| 1053862862 | Joshua Waddell | Nurse Practitioner | 3686 Us Highway 331 S, Defuniak Springs, FL 32435-8463 | 2016-10-17 |
| 1518358258 | Molly B Fulmer | Social Worker | 3686 Us Highway 331 S, Defuniak Springs, FL 32435-8463 | 2015-02-17 |
| 1346673506 | Jacquelyn Joy Broadus | Counselor | 3686 Us Highway 331 S, Defuniak Springs, FL 32435-8463 | 2013-08-12 |
| 1710235049 | Constance Jean White | Social Worker | 3686 Us Highway 331 S, Defuniak Springs, FL 32435-8463 | 2012-08-16 |
| 1912262692 | Debra Ann Dougherty | Social Worker | 3686 Us Highway 331 S, Defuniak Springs, FL 32435-8463 | 2012-07-09 |
| 1962773044 | Kimberly Denise Ray | Counselor | 3686 Us Highway 331 S, Defuniak Springs, FL 32435-8463 | 2012-01-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477098267 | Luz Zondlo | Counselor | 3686 Us Highway 331s, Chautauqua Offices of Psychotherapy & Evaluation, Defuniak Springs, FL 32435 | 2017-01-03 |
| 1427445477 | Jacob Urda | Family Medicine | 1045 Hwy 331 South Suite D & E, Defuniak Springs, FL 32435 | 2015-04-16 |
| 1982728929 | Stone Surgery Clinic | Surgery | 962 Us 331 South, Defuniak Springs, FL 32435 | 2007-03-16 |
| 1003999756 | Charles Gordon Stevenson IIi | Optometrist | 770 Hwy 331 South, Suite 1, Defuniak Springs, FL 32435 | 2006-10-23 |
| 1609971910 | Solomon Reodica | Surgery | 4415 Highway 331 Soutn, Defuniak Springs, FL 32435 | 2006-09-13 |
| 1396857223 | Pamela Kay Stuckey | Social Worker | 3686 Us Hwy 331 S, Cope Center Inc, Defuniak Springs, FL 32435 | 2006-08-31 |
| 1144332065 | Michele Anne Gilmore-rule | Social Worker | 3686 Us Hwy 331 South, Cope Center Inc, De Funiak Springs, FL 32435 | 2006-08-31 |
| 1205857513 | Winn Dixie Stores Inc | Durable Medical Equipment & Medical Supplies | 1030 Us Highway 331 South, Suite G, Defuniak Springs, FL 32435 | 2006-07-21 |
| 1912932153 | George Lester Mueller | Surgery | 2800 S Seacrest, Suite 200, Boynton Beach, FL 32435 | 2006-07-12 |
| 1679525463 | Timothy W Walker | Emergency Medicine | 4413 Us Hwy 331 South, Defuniak Springs, FL 32435 | 2006-05-17 |
| Find all providers in zip 32435 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457959066 | Kecia Hicks | Nurse Practitioner | 691 Institution Rd, Defuniak Springs, FL 32433-1850 | 2020-10-15 |
| 1053862862 | Joshua Waddell | Nurse Practitioner | 3686 Us Highway 331 S, Defuniak Springs, FL 32435-8463 | 2016-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295336832 | Marco Desouza | Nurse Practitioner | 10235 Avelar Ridge Dr, Riverview, FL 33578-7560 | 2020-11-02 |
| 1457950107 | Janet Rosemarie Walker | Nurse Practitioner | 9988 Sw 38th Ave, Ocala, FL 34476-4082 | 2020-10-23 |
| 1104425800 | Vijayalakshmi Kumaraguru | Nurse Practitioner | 102 Park Place Blvd Ste D1, Kissimmee, FL 34741-2358 | 2020-10-22 |
| 1356940217 | Smitha Ajesh | Nurse Practitioner | 9833 Westview Dr Apt 829, Coral Springs, FL 33076-2537 | 2020-10-21 |
| 1699372003 | Rosie Michel | Nurse Practitioner | 13000 Ne 12th Ave, North Miami, FL 33161-4305 | 2020-10-08 |
| 1952908352 | Karen Weinstock | Nurse Practitioner | 7148 Sportsmans Dr, North Lauderdale, FL 33068-5456 | 2020-10-08 |
| 1396342754 | Pamela Ziel | Nurse Practitioner | 545 Lakeside Cir, Sunrise, FL 33326-2136 | 2020-10-07 |
| 1922615608 | Urszula Dorfman | Nurse Practitioner | 1 Las Olas Cir Apt 609, Fort Lauderdale, FL 33316-1634 | 2020-09-28 |
| 1073129136 | Karen Harris | Nurse Practitioner | 28211 Church Rd, Brooksville, FL 34602-6232 | 2020-09-23 |
| 1538775366 | Rebecca Marie Deroche | Nurse Practitioner | 10810 Mcgregor Blvd, Fort Myers, FL 33919-1846 | 2020-09-17 |
| Find all providers with the same taxonomy | ||||
| City | DEFUNIAK SPRINGS |
| Zip Code | 32435 |
Please comment or provide details below to improve the information on WILLARD MARVIN ANDERSON III.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.