Individual
STEPHANIE ANN WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
601 CHILDRENS LN, NORFOLK, VA 23507-1910
(757) 668-9222
(757) 668-7568
Mailing address
811 REDGATE AVE, NORFOLK, VA 23507-1515
(757) 668-7007
(757) 668-8658
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001244829
VA
363L00000X
Nurse Practitioner
Primary
0024179867
VA
Other
Enumeration date
04/01/2020
Last updated
12/21/2021
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