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NPI Code Detail

MEDICARE: NANETTE WILLIS LSW

MEDICARE: NANETTE WILLIS LSW
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
1104100000XSocial WorkerS.0019534OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396893434
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANETTE WILLIS LSW
Provider Business Mailing Address
First Line : 419 VERNON ST
Second Line :
City : IRONTON
State : OH
Zip : 45638-1637
Country : US
Telephone Number : 740-479-5118
Fax Number : 740-532-0557
Provider Business Practice Location Address
First Line : 419 VERNON ST
Second Line :
City : IRONTON
State : OH
Zip : 45638-1637
Country : US
Telephone Number : 740-479-5120
Fax Number : 740-529-1400
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2007
Last Update Date : 07/17/2025

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Directions to “ NANETTE WILLIS LSW” Practice Location

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