Individual
MRS. GERALDINE P WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6237 MARIPOSA AVE, TWENTYNINE PALMS, CA 92277-2030
(760) 799-5612
Mailing address
6237 MARIPOSA AVE, TWENTYNINE PALMS, CA 92277-2030
(760) 799-5612
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
217986
CA
Other
Enumeration date
08/03/2008
Last updated
08/03/2008
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