| Doctor Name: | MRS. MELANIA J WILLIS |
| NPI Number: | 1013927995 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | 2734962 |
| Business Practice Address: | 701 Ohio Ave S Live Oak, FL - 320643816 |
| Business Phone Number: | 3863305248 |
| Business Fax Number: | 3862081380 |
| Mailing Address: | 7500 S County Road 125, MACCLENNY |
| State: | FL |
| Postal Code: | 320635328 |
| Phone Number: | 9042599257 |
| Fax Number: | |
| NPI Enumeration Date: | 08/09/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 2734962 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |