Individual
ESTELLA E WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
919 W 20TH ST, LORAIN, OH 44052-3860
(440) 381-0729
Mailing address
919 W 20TH ST, LORAIN, OH 44052-3860
(440) 381-0729
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
150468
OH
Other
Enumeration date
11/08/2012
Last updated
11/08/2012
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