Individual
ANGELIQUE WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
217 ASHBROOK ST, SAINT AUGUSTINE, FL 32084-0086
(904) 599-9192
Mailing address
217 ASHBROOK ST, SAINT AUGUSTINE, FL 32084-0086
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN11042009
FL
Other
Enumeration date
09/13/2025
Last updated
09/13/2025
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