Individual
GENEVIEVE WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
4820 E MAIN ST, FARMINGTON, NM 87402-8660
(505) 609-6495
Mailing address
PO BOX 844088, DALLAS, TX 75284-4088
(505) 609-2258
(505) 609-2259
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
62794
NM
Other
Enumeration date
02/03/2021
Last updated
11/15/2024
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