Provider Demographics
NPI:1174047013
Name:WILLSEY, DEBRA LUCILLE (FNP PSYCH)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:LUCILLE
Last Name:WILLSEY
Suffix:
Gender:F
Credentials:FNP PSYCH
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:LUCILLE
Other - Last Name:ARCOVIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:571 SAINT JOSEPHS BLVD FL 2
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-3230
Mailing Address - Country:US
Mailing Address - Phone:607-271-2050
Mailing Address - Fax:
Practice Address - Street 1:555 SAINT JOSEPHS BLVD
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-3223
Practice Address - Country:US
Practice Address - Phone:607-737-7002
Practice Address - Fax:607-271-3435
Is Sole Proprietor?:No
Enumeration Date:2017-08-02
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY402245363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health