Individual
LAURA JANELLE WILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
105 W 8TH AVE STE 6050, SPOKANE, WA 99204-2312
(509) 455-8866
(509) 227-7070
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(866) 747-2455
(509) 227-7070
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP30005180
WA
363LF0000X
Family Nurse Practitioner
RN00079210
WA
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
AP30005180
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
806837800
IDAHO MEDICAID
ID
05
—
9624537
—
WA
01
—
A008
TRIWEST
WA
Enumeration date
08/15/2005
Last updated
03/25/2022
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