Healthcare Provider Details

I. General information

NPI: 1538545546
Provider Name (Legal Business Name): EMILY W WILLIS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY E WHEELER

II. Dates (important events)

Enumeration Date: 08/03/2015
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13710 ST FRANCIS BLVD
MIDLOTHIAN VA
23114-3267
US

IV. Provider business mailing address

4600 MCAULEY PL STE 600
BLUE ASH OH
45242-4778
US

V. Phone/Fax

Practice location:
  • Phone: 804-594-7300
  • Fax: 877-536-1730
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024172759
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: