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Individual

MS. DANINE THERESA WILLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
4807 E 181ST ST, OVERBROOK, KS 66524-9505
(785) 438-0309
Mailing address
4807 E 181ST ST, OVERBROOK, KS 66524-9505
(785) 438-0309

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
53-44929
KS
363L00000X
Nurse Practitioner
A004899
AR
363LF0000X
Family Nurse Practitioner
2004033676
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100352890C
KS
Enumeration date
02/23/2006
Last updated
03/12/2026
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