Provider Demographics
NPI:1831896869
Name:WILLMAN, MAGGIE MARIE (APRN)
Entity type:Individual
Prefix:
First Name:MAGGIE
Middle Name:MARIE
Last Name:WILLMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7313 MANSLICK RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40214-4137
Mailing Address - Country:US
Mailing Address - Phone:502-263-3862
Mailing Address - Fax:
Practice Address - Street 1:231 E CHESTNUT ST STE 334
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1821
Practice Address - Country:US
Practice Address - Phone:502-882-9237
Practice Address - Fax:502-893-3900
Is Sole Proprietor?:No
Enumeration Date:2023-02-09
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3018818207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine