Individual
MRS. CARMEN RENEE WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
495 COUNTY ROAD 971, CUSHING, TX 75760-3734
(936) 652-3870
Mailing address
495 COUNTY ROAD 971, CUSHING, TX 75760-3734
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP138180
TX
Other
Enumeration date
07/24/2018
Last updated
07/24/2018
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