Individual
MRS. MICHELE LYNN WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-8355
(270) 461-2199
Mailing address
987 GARFIELD WAY, CLARKSVILLE, TN 37042-3375
(719) 200-6531
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
330953
NABP
—
Enumeration date
04/24/2026
Last updated
04/24/2026
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