Individual
LEE WILLINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3625 UNIVERSITY BLVD S, JACKSONVILLE, FL 32216-4207
(904) 702-6111
Mailing address
7651 GATE PKWY APT 2208, JACKSONVILLE, FL 32256-4822
(770) 315-5101
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9438255
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
246202
GA
Other
Enumeration date
12/04/2019
Last updated
06/02/2022
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