Individual
MRS. JENNIFER TRICIA WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2608 CREST VALLEY DRIVE, CONYERS, GA 30094
(404) 428-2237
(404) 428-2237
Mailing address
2608 CREST VALLEY DRIVE, CONYERS, GA 30094
(770) 648-8237
(770) 648-8237
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
180459
GA
Other
Enumeration date
09/12/2005
Last updated
12/23/2015
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