Individual
CARRIE ANGELA WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4000 KRESGE WAY, LOUISVILLE, LOUISVILLE, KY 40207-4605
(502) 473-2132
(502) 459-0923
Mailing address
PO BOX 34748, LOUISVILLE, KY 40232-4748
(502) 473-2132
(502) 459-0923
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1096463
KY
367500000X
Certified Registered Nurse Anesthetist
Primary
3005926
KY
Other
Enumeration date
12/22/2008
Last updated
06/19/2013
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