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1306873732
TANYA WILLIS
JACKSON, MS
NPI
1306873732
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LN0000X Nurse Practitioner, Neonatal
(Licence: MS R851015)
Enumeration Date
2006-06-28
Last Update Date
2012-06-14
Business Address
-- TANYA WILLIS CNNP
2500 N STATE ST
JACKSON, MS 39216-4500
Phone number: 601-984-5260
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Mailing Address
-- TANYA WILLIS CNNP
2500 N STATE ST
JACKSON, MS 39216-4500
Phone number: 601-984-5260
Copy
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