Individual
MS. DIANNE KAY WILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
2105 EAST SOUTH BOULEVARD, ATTN; PALLIATIVE CARE, MONTGOMERY, AL 36116-2509
(334) 286-2987
(334) 286-3368
Mailing address
301 BROWN SPRINGS ROAD, ATTN: PROVIDER ENROLLMENT, MONTGOMERY, AL 36117-7005
(334) 273-4508
(334) 273-4290
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-041345
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051000325
BC SOUTH
AL
01
—
051525630
BC PRATTVILLE
AL
01
—
051525631
BC EAST
AL
05
—
891008780
—
AL
05
—
891008990
—
AL
05
—
891009010
—
AL
Enumeration date
08/01/2006
Last updated
06/17/2014
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