Individual
LISA WILLETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2213 2ND ST, CORALVILLE, IA 52241-1205
(319) 358-2406
Mailing address
2213 2ND ST, CORALVILLE, IA 52241-1205
(319) 338-0581
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P36063
IA
Other
Enumeration date
11/14/2025
Last updated
11/14/2025
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