Individual
MS. MICHELLE RENE WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
3901 E 32ND ST, JOPLIN, MO 64804-3312
(417) 347-7600
Mailing address
423 5TH ST, OSWEGO, KS 67356-2101
(620) 423-4266
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
53-78546-122
KS
Other
Enumeration date
01/26/2019
Last updated
01/26/2019
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