Individual
MRS. QUATINA WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
612 KESWICK VILLAGE CT NE, CONYERS, GA 30013-6523
(678) 281-4542
(678) 253-4118
Mailing address
612 KESWICK VILLAGE CT NE, CONYERS, GA 30013-6523
(678) 800-5091
(678) 609-0592
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN066567
GA
Other
Enumeration date
08/16/2012
Last updated
03/17/2023
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