Individual
KENYA WASHINGTON WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
300 SOUTHFIELD RD, SHREVEPORT, LA 71105-4112
(318) 219-9554
(318) 868-5373
Mailing address
300 SOUTHFIELD RD, SHREVEPORT, LA 71105-4112
(318) 219-9554
(318) 868-5373
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16700
LA
Other
Enumeration date
08/02/2011
Last updated
08/02/2011
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