Individual
MALLORY ELISE WILLETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
611 DUNCAN AVE, PITTSBURGH, PA 15237-5854
(412) 358-8690
Mailing address
1200 INGHAM ST, PITTSBURGH, PA 15212-2840
(724) 263-0741
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP018132
PA
Other
Enumeration date
11/19/2017
Last updated
04/20/2018
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