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Individual

PAIGE WILLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
5501 N PORTLAND AVE, ANESTHESIA DEPARTMENT, OKLAHOMA CITY, OK 73112-2074
(918) 710-5114
Mailing address
19004 BUTTERFLY BLVD, EDMOND, OK 73012-9640
(785) 764-2848

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
103716
KS
367500000X
Certified Registered Nurse Anesthetist
Primary
115300
OK

Other

Enumeration date
06/15/2015
Last updated
05/18/2016
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