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Individual

AMY LEIGH WILLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
25647 REDWOOD HWY, CAVE JUNCTION, OR 97523-9332
(541) 592-4111
(541) 494-1099
Mailing address
1701 NW HAWTHORNE AVE, GRANTS PASS, OR 97526-1051
(541) 472-4777

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
201403235NP-PP
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
201909238NP-PP
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500673795
OR
01
R175366
MEDICARE PTAN
OR
Enumeration date
06/09/2014
Last updated
10/24/2022
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