Individual
ANGELA SUE WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
500 3RD ST, WEST DES MOINES, IA 50265-4614
(515) 263-0608
Mailing address
500 3RD ST, WEST DES MOINES, IA 50265-4614
(515) 263-0608
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P55915
IA
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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