Individual
GENNICE JENAIL WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12017 DAHOON DR, OKLAHOMA CITY, OK 73120-8131
(405) 313-8685
(877) 719-2739
Mailing address
12017 DAHOON DR, OKLAHOMA CITY, OK 73120-8131
(405) 313-8685
(877) 719-2739
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
37H041801211
OK
253Z00000X
In Home Supportive Care Agency
37V261041204
OK
374U00000X
Home Health Aide
Primary
37V261041204
OK
376K00000X
Nurse's Aide
37H041801211
NY
376K00000X
Nurse's Aide
37H041801211
OK
Other
Enumeration date
01/24/2017
Last updated
01/24/2017
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