Individual
DEBRA BROWN WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
216 BELLE OAK DR, BRANDON, MS 39042-8251
(601) 209-8037
Mailing address
216 BELLE OAK DR, BRANDON, MS 39042-8251
(601) 209-8037
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
2017003142
MS
363LA2200X
Adult Health Nurse Practitioner
Primary
AP133899
TX
363LG0600X
Gerontology Nurse Practitioner
2017003142
MS
363LP2300X
Primary Care Nurse Practitioner
2017003142
MS
Other
Enumeration date
03/15/2017
Last updated
10/05/2017
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