Individual
LORRIE WILLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
12207 N 113TH AVE, YOUNGTOWN, AZ 85363-1208
(858) 242-6486
Mailing address
16845 N 29TH AVE STE 1406, PHOENIX, AZ 85053-0412
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
729022
CA
363LF0000X
Family Nurse Practitioner
Primary
95012682
CA
Other
Enumeration date
02/10/2020
Last updated
07/06/2020
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