Individual
MS. TONIA ANITRA WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C-NP
Contact information
Practice address
14102 SAINT MARYS ST, DETROIT, MI 48227
(313) 673-8076
Mailing address
14102 SAINT MARYS ST, DETROIT, MI 48227
(313) 673-8076
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
4704249744
MI
Other
Enumeration date
04/04/2012
Last updated
04/04/2012
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