Individual provider · Type 1 NPI

Deidra Willis, A- GNP

Primary Care Nurse Practitioner · Columbia, SC

NPI number 1114452901 Active

Practice location

6439 Garners Ferry Rd
Columbia, SC 29209-1638

Call (803) 776-4000 Map

Mailing address

160 Katrina Ct
Lexington, SC 29073-6924

Specialties and licenses

TaxonomyCodeLicense
Primary Care Nurse Practitioner Primary 363LP2300X20835 (SC)

Primary Care Nurse Practitioner: Definition to come...

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About NPI 1114452901

Deidra Willis, A- GNP's National Provider Identifier is 1114452901, issued on Apr 29, 2017. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Columbia, SC. The record was last updated on Apr 29, 2017.