Individual
REVONDA WILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
365 COURTHOUSE RD, PRINCETON, WV 24740-2431
(304) 425-3922
Mailing address
365 COURTHOUSE RD, PRINCETON, WV 24740-2431
(304) 425-3922
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
105555
WV
Other
Enumeration date
05/19/2020
Last updated
05/19/2020
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