Individual ProviderPaula WillisLicensed Practical NurseNursing Service ProvidersPractice Address17 Somerset Rd N, Amityville, NY 11701-2035(516) 362-8061PECOS EnrollmentBased on the most recent information from CMS, provider Paula Willis does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:26 AM.Profile DetailsProvider ID1013461177Provider TypeIndividualFull NameWillis, PaulaCredentialLPNGenderFemaleSole ProprietorYesEnumeration Date8/6/2016Last Updated8/6/2016Contact InformationPractice LocationPractice Address17 Somerset Rd N, Amityville, NY 11701-2035Phone(516) 362-8061FaxUnlisted FaxMailing LocationMailing Address17 Somerset Rd N, Amityville, NY 11701-2035PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode164W00000XPrimaryDescriptionLicensed Practical NurseNursing Service ProvidersLicense317000New York