Individual
MRS. MARY E WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
10510 JEFFERSON AVE STE E, NEWPORT NEWS, VA 23601-3102
(757) 594-2846
(757) 594-1714
Mailing address
856 J CLYDE MORRIS BLVD STE A, NEWPORT NEWS, VA 23601-1318
(757) 316-5800
(757) 534-5190
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
0024175643
VA
Other
Enumeration date
01/25/2018
Last updated
01/25/2018
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