NICOLE WILLIS (NPI# 1093992539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093992539 |
| Entity Type | Individual |
| Full Name | NICOLE WILLIS |
| Other Name | DAWN NICOLE WILLIS |
| Credential | D.C. |
| Practice Address |
1570 E Heritage Park St Ste 175 Meridian ID 83646-6445 |
| Practice Telephone | 2083224114 |
| Practice Fax Number | 2083224115 |
| Mailing Telephone | 2083224114 |
| Mailing Fax Number | 2083224115 |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2020-01-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | CHIA-1268 | ID | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GROUP PTAN | 1370103 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992354039 | Nicole Willis | Behavior Technician | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2019-09-11 |
| 1881066736 | Nicole Willis | Social Worker | 4500 S Lancaster Rd, Dallas, TX 75216-7167 | 2015-10-30 |
| 1235519307 | Nicole Marie Willis | Specialist | 538 Broadhollow Rd Ste 202, Melville, NY 11747-3668 | 2015-06-04 |
| 1831428143 | Nicole Willis | Pediatrics | 15951 Little Axe Drive, Norman, OK 73026 | 2009-12-15 |
| 1235331232 | Nicole Rae Willis | Occupational Therapist | 4500 S Washington St - Altru Specialty Center, Grand Forks, ND 58201 | 2007-06-01 |
| Street Address |
1570 E HERITAGE PARK ST STE 175 |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83646-6445 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104869841 | Michael W Hurd | Dentist | 1570 E Heritage Park St, Suite 175, Meridian, ID 83646 | 2006-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982202743 | Jayson Paul Smith | Nurse Practitioner | 1545 East Leighfield Dr., Meridian, ID 83646 | 2020-10-14 |
| 1356977466 | Tanabell Health Services Inc | Assisted Living Facility | 2584 E Magic View Dr, Meridian, ID 83646 | 2020-03-20 |
| 1801351176 | Tanabell Health Services, Inc. | Skilled Nursing Facility | 2656 E Magicview Dr, Meridian, ID 83646 | 2019-01-31 |
| 1306314323 | Cr Smiles - Meridian Dental Care LLC | Clinic/Center | 1500 W Cayuse Creek Dr, #100, Meridian, ID 83646 | 2018-11-07 |
| 1639644107 | Joseph Anomalay | Counselor | 6700 N. Linder Rd, Ste 156 #257, Meridian, ID 83646 | 2018-10-10 |
| 1275015950 | Mcmillan Family Dental Pllc | Clinic/Center | 1720 W. Mcmillan, Meridian, ID 83646 | 2018-08-30 |
| 1609327022 | Finding Home Healthcare, Inc. | Clinic/Center | 55 W Willowbrook Dr Ste 103, Meridian, ID 83646 | 2016-10-20 |
| 1952857161 | Mitchell Truong | Pharmacist | 622 E. Ustick Road, Caldwell, ID 83646 | 2016-08-28 |
| 1134511264 | Brittany Laub | Massage Therapist | 2572 N Stokesberry Pl #300, Meridian, ID 83646 | 2015-02-26 |
| 1194117366 | Westfall Ventures, Inc | Health Maintenance Organization | 2572 N. Stokesberry Pl, Meridian, ID 83646 | 2015-02-25 |
| Find all providers in zip 83646 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568093136 | Allcorp LLC | Chiropractor | 1948 S Eagle Rd, Meridian, ID 83642-2452 | 2020-01-31 |
| 1083274260 | Chiropractic Billing Center | Chiropractor | 520 S Meridian Rd Ste 60, Meridian, ID 83642-4533 | 2019-06-19 |
| 1891270229 | Slonaker Enterprises, LLC | Chiropractor | 3329 W Cherry Ln, Meridian, ID 83642-1119 | 2018-10-02 |
| 1316425960 | Chad William Queen | Chiropractor | 3088 W Tenuta St, Meridian, ID 83646-3216 | 2018-08-04 |
| 1841707007 | William Clayton Ramos | Chiropractor | 1735 W Franklin Rd, Meridian, ID 83642-8330 | 2018-01-09 |
| 1811402431 | Evergreen Wellness Partners, LLC | Chiropractor | 1710 W Cherry Ln, Meridian, ID 83642-1340 | 2017-12-05 |
| 1235641374 | Raymond Drew Flack | Chiropractor | 3405 E Overland Rd Ste 110, Meridian, ID 83642-5111 | 2017-10-30 |
| 1598281321 | White Brothers Investments | Chiropractor | 1520 E Heritage Park St Ste 150, Meridian, ID 83646-5886 | 2017-08-14 |
| 1306368188 | Hailey Haugen | Chiropractor | 3085 E Magic View Dr # 180, Meridian, ID 83642-3757 | 2017-07-12 |
| 1457885170 | Mobile Chiropractic and Wellness Pllc | Chiropractor | 3784 N Chocaya Pl, Meridian, ID 83646-6075 | 2017-04-19 |
| Find all providers in MERIDIAN | ||||
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| 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.