Individual
WILLIE SELLERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AGACNP-BC
Contact information
Practice address
15354 W CHARTER OAK RD, SURPRISE, AZ 85379-9184
(843) 616-4948
Mailing address
15354 W CHARTER OAK RD, SURPRISE, AZ 85379-9184
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
248870
AZ
Other
Enumeration date
10/08/2020
Last updated
10/08/2020
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