Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jackie Willis

Individual provider Peer Specialist · NPI 1881470979

Jackie Willis is a Peer Specialist in Louisa, Kentucky. Practices as a sole proprietor. Registered with an NPI since 2023.

In the registry since
2023
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Practice location Address checks out

125 S Main Cross St
Louisa, KY 41230-1065
Phone: (606) 638-0938
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Peer Specialist (primary) Taxonomy 175T00000X

Record details

NPI number1881470979
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedSeptember 5, 2023
Last updated in NPPESSeptember 5, 2023
Certification dateSeptember 5, 2023
Mailing address332 River Bend Rd, Louisa, KY 41230-1407

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