Provider Demographics
NPI:1184115446
Name:WILLMANN, ANNE MARIE (APN)
Entity type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:MARIE
Last Name:WILLMANN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MRS
Other - First Name:ANNE
Other - Middle Name:MARIE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2246 BLUEGRAMA DR
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41005-6800
Mailing Address - Country:US
Mailing Address - Phone:859-992-5121
Mailing Address - Fax:
Practice Address - Street 1:11 PARKLANDS DR UNIT 2218
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-5198
Practice Address - Country:US
Practice Address - Phone:859-992-5121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-22
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21831363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily