Individual
MRS. KRISTIE WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
509 N BRIGHTLEAF BLVD, SMITHFIELD, NC 27577-4407
(919) 938-7188
Mailing address
1024 BLYKEFORD LANE, WAKE FOREST, NC 27587
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
128155
NC
Other
Enumeration date
09/13/2006
Last updated
07/08/2007
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