Individual
PATRICIA ANN WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3458 WESTWOOD DR, SALT LAKE CITY, UT 84109-3239
(801) 278-8975
Mailing address
3458 WESTWOOD DR, SALT LAKE CITY, UT 84109-3239
(801) 278-8975
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
198463-3102
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
198463-3102
DOPL - REGISTERED NURSE
UT
Enumeration date
03/24/2008
Last updated
03/24/2008
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