Organization
A WILLING NOBLE SERVICES LLC
Active
Other names
A Willing Noble Services LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHERINE NICOLE WILLINGHAM APRN (APRN)
(561) 755-1797
Entity
Organization
Contact information
Practice address
2151 SW BARTHEL ST, PORT SAINT LUCIE, FL 34984-4301
(561) 755-1797
(480) 906-1475
Mailing address
2151 SW BARTHEL ST, PORT SAINT LUCIE, FL 34984-4301
(561) 755-1797
(480) 906-1475
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
315P00000X
Intellectual Disabilities Intermediate Care Facility
—
—
363L00000X
Nurse Practitioner
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
05/16/2023
Last updated
05/16/2023
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