DEIDRA WILLIS

COLUMBIA, SC
NPI1114452901
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP2300X Nurse Practitioner Primary Care
(Licence: SC  20835)
Enumeration Date2017-04-29
Last Update Date2017-04-29
Business Address
DEIDRA WILLIS A- GNP
6439 GARNERS FERRY RD
COLUMBIA, SC 29209-1638
Phone number: 803-776-4000
Mailing Address
DEIDRA WILLIS A- GNP
160 KATRINA CT
LEXINGTON, SC 29073-6924
Phone number: 803-413-8700
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