Individual
REGINA RENEE WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
5015 SHED RD STE 500, BOSSIER CITY, LA 71111-5587
(318) 741-5858
(318) 741-4496
Mailing address
5015 SHED RD, BOSSIER CITY, LA 71111-5584
(318) 741-5858
(318) 741-4496
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
RN054611
LA
363LX0106X
Occupational Health Nurse Practitioner
Primary
AP05016
LA
Other
Enumeration date
12/04/2006
Last updated
06/16/2018
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