Jacquelyn Willis
Licensed Practical Nurse • Green Brook, NJ
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Jacquelyn Willis has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Jacquelyn Willis was a registered Licensed Practical Nurse practicing in Green Brook, NJ. Throughout an active medical career spanning 18 years, Jacquelyn Willis provided care at the practice location at 275 GREENBROOK RD until profile deactivation on 2025-03-20.
Practice Location & Contact Primary Location
275 Greenbrook Rd
Green Brook, NJ 088122223
Specialty Benchmarks & Practice Insights
Comparative analytics for Licensed Practical Nurse in Green Brook, NJ
Practicing in Green Brook, NJ (1119 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 164W00000X
An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
Practice Associates & Co-Workers
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Psychiatric Hospital
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on March 20, 2025
NPI status registered as active in NPPES database
Registered at 275 GREENBROOK RD, GREEN BROOK, NJ 088122223 (Tel: 7329686000)
Registered at 45 SEMEL AVE, ISELIN, NJ 088301333
Recorded as JACQUELYN WILLIS
Licensed Practical Nurse
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
45 Semel Ave
Iselin, NJ 088301333
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