Individual
MRS. KATHIE JO WILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
94235 MOORE ST, GOLD BEACH, OR 97444
(541) 247-3300
Mailing address
PO BOX 746, GOLD BEACH, OR 97444-0746
(541) 247-3300
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
000030721
OR
Other
Enumeration date
01/19/2012
Last updated
01/19/2012
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