Individual
PATRICIA ANN WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-BC
Contact information
Practice address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 652-4100
(314) 289-6442
Mailing address
915 N GRAND BLVD, VA ST LOUIS HEALTH CARE SYSTEM, SAINT LOUIS, MO 63106-1621
(314) 652-4100
(314) 289-6442
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
2012000258
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120630
RN LICENSE
MO
01
—
2012000258
NURSE PRACTITIONER LICENSE
MO
Enumeration date
09/08/2014
Last updated
09/08/2014
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