Individual
PRISCILLA K WILLANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
101 WILLMAR AVE SW, WILLMAR, MN 56201-3556
(320) 231-5000
(320) 231-5067
Mailing address
101 WILLMAR AVE SW, WILLMAR, MN 56201-3556
(320) 231-5000
(320) 231-5067
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0678
SD
363A00000X
Physician Assistant
Primary
10486
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0678
STATE LICENSE NUMBER
SD
01
—
10486
STATE LICENSE NUMBER
MN
Enumeration date
05/08/2008
Last updated
09/18/2008
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