MEDICARE: A WILLING NOBLE SERVICES LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251C00000X	Developmentally Disabled Services Day Training Agency
2	261QA0600X	Adult Day Care Clinic/Center
3	261QD1600X	Developmental Disabilities Clinic/Center
4	315P00000X	Intellectual Disabilities Intermediate Care Facility
5	385H00000X	Respite Care
6	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1124719604
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A WILLING NOBLE SERVICES LLC

Provider Business Mailing Address
First Line	:	2151 SW BARTHEL ST
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34984-4301
Country	:	US
Telephone Number	:	561-755-1797
Fax Number	:	480-906-1475

Provider Business Practice Location Address
First Line	:	2151 SW BARTHEL ST
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34984-4301
Country	:	US
Telephone Number	:	561-755-1797
Fax Number	:	480-906-1475

Authorized Official
Title or Position	:	APRN
Name	:	MRS. KATHERINE NICOLE WILLINGHAM
Credential	:	APRN
Telephone Number	:	561-755-1797

Provider Enumeration Date	:	05/16/2023
Last Update Date	:	05/16/2023

Similar Medicare Providers

1306315825 — MRS. KATHERINE NICOLE WILLINGHAM APRN
Practice Location Address:

2151 SW BARTHEL ST
PORT SAINT LUCIE, FL
34984-4301

Practice Phone: 772-785-9419
Practice Fax:

1720616014 — KNW MEDICAL SERVICES LLC
Practice Location Address:

2151 SW BARTHEL ST
PORT SAINT LUCIE, FL
34984-4301

Practice Phone: 772-785-9419
Practice Fax: 772-785-9419

1114913613 — DR. JERRY M PAYNE DC
Practice Location Address:

1217 E 1ST ST
PORT ANGELES, WA
98362-4301

Practice Phone: 360-452-3017
Practice Fax: 360-452-4100

1922085109 — PATRICIA LEE GILCHRIST LCSW
Practice Location Address:

13294 COMMONWEALTH AVE
PORT CHARLOTTE, FL
33981-4301

Practice Phone: 941-276-5096
Practice Fax: 941-698-1045

1396929006 — JERRY M PAYNE D.C., INC
Practice Location Address:

1217 E 1ST ST
PORT ANGELES, WA
98362-4301

Practice Phone: 360-452-3017
Practice Fax: 360-452-4100

1912350604 — KIMBERLEE MCCARREN
Practice Location Address:

3032 TONKIN DR
NORTH PORT, FL
34287-4301

Practice Phone: 941-525-7994
Practice Fax:

Directions to “A WILLING NOBLE SERVICES LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.