Individual
DENISE LYNNE WILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
629 GALLAHER RD, KINGSTON, TN 37763-4215
(865) 376-3416
Mailing address
629 GALLAHER RD, KINGSTON, TN 37763-4215
(865) 376-3416
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN112216
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN112216
RN LICENSE
TN
Enumeration date
05/24/2019
Last updated
05/24/2019
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