Individual
ANGELA LEE WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5651 FRIST BLVD, SUITE 713, HERMITAGE, TN 37076-2054
(615) 316-5662
(615) 316-5666
Mailing address
5651 FRIST BLVD, SUITE 713, HERMITAGE, TN 37076-2054
(615) 316-5662
(615) 316-5666
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
40253
TN
207Q00000X
Family Medicine Physician
MD40253
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3335851
—
TN
Enumeration date
10/17/2005
Last updated
04/11/2016
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