Individual
KIMBERLY D WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP RN
Contact information
Practice address
166 STONERIDGE DRIVE, COLUMBIA, SC 29210
(803) 461-3000
(803) 461-4903
Mailing address
166 STONERIDGE DRIVE, COLUMBIA, SC 29210
(803) 461-3000
(803) 461-4903
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2015
SC
Other
Enumeration date
02/22/2007
Last updated
07/08/2016
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