Individual
CHRISTINA M WILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1107 CROWN POINTE DR STE 107, ELIZABETHTOWN, KY 42701-7280
(270) 506-3300
(270) 506-2843
Mailing address
120 EXECUTIVE PARK, LOUISVILLE, KY 40207-4201
(502) 907-0356
(502) 919-9780
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3010911
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300005142
—
IN
05
—
7100471480
—
KY
Enumeration date
12/20/2016
Last updated
06/24/2019
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