Provider Demographics
NPI:1457375552
Name:WILLETT, PAULA MARY (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:MARY
Last Name:WILLETT
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
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Mailing Address - Street 1:1124 GLOUCESTER CT S
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-7505
Mailing Address - Country:US
Mailing Address - Phone:972-252-2543
Mailing Address - Fax:
Practice Address - Street 1:6750 N MACARTHUR BLVD STE 210
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-2473
Practice Address - Country:US
Practice Address - Phone:972-869-1330
Practice Address - Fax:972-869-1337
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX615919363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily