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General NPI Number Information
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NPI Number | 1891447744
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Entity Type | Individual
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Provider Name | MASIAI WILLIS-JONES APRN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 01/21/2022
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Last Update Date | 03/12/2026
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Provider Practice Location Address
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Address Line | 1066 SW GATLIN BLVD
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City | PORT ST LUCIE
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State | FL
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Zip | 34953-3223
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Country | US
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Telephone | 772-879-8080
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Fax | 772-324-9347
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Provider Business Mailing Address
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Address Line | 1066 SW GATLIN BLVD
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34953-3223
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Country | US
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Telephone | 772-879-8080
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Fax | 772-324-9347
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11017794
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F01220755
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License Number State | FL
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