Individual
JENNY LYNN WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1072 LASKIN RD STE 104, VIRGINIA BEACH, VA 23451-6387
(757) 648-8605
(757) 648-1363
Mailing address
1072 LASKIN RD STE 104, VIRGINIA BEACH, VA 23451-6387
(757) 648-8605
(757) 648-1363
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
0001227478
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024172939
VA
Other
Enumeration date
09/16/2015
Last updated
05/23/2025
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