Provider Demographics
NPI:1427198530
Name:PRICE, WILLA JANE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:WILLA
Middle Name:JANE
Last Name:PRICE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3690 SAINT JOHNS BLUFF RD S
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-2616
Mailing Address - Country:US
Mailing Address - Phone:904-645-6767
Mailing Address - Fax:904-645-0145
Practice Address - Street 1:3690 SAINT JOHNS BLUFF RD S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-2616
Practice Address - Country:US
Practice Address - Phone:904-645-6767
Practice Address - Fax:904-645-0145
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2722862363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE4916YMedicare ID - Type Unspecified