MEDICARE: YANNA WILLS APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	11045139	FL

General Provider Information

NPI Number	:	1083980437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YANNA WILLS APRN

Provider Business Mailing Address
First Line	:	PO BOX 120026
Second Line	:
City	:	WEST MELBOURNE
State	:	FL
Zip	:	32912-0026
Country	:	US
Telephone Number	:	561-898-2337
Fax Number	:

Provider Business Practice Location Address
First Line	:	4478 ALLIGATOR FLAG CIR
Second Line	:
City	:	WEST MELBOURNE
State	:	FL
Zip	:	32904-8198
Country	:	US
Telephone Number	:	561-898-2337
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2012
Last Update Date	:	03/04/2026

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