Individual provider · Type 1 NPI

Konneen Willis, PA

Medical Physician Assistant · Bountiful, UT

NPI number 1861510240 Active

Practice location

1551 Renaissance Towne Dr, Ste 460
Bountiful, UT 84010-7667

Fax (801) 294-2560

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X107354-1206 (UT)

Medical Physician Assistant: Definition to come...

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About NPI 1861510240

Konneen Willis, PA's National Provider Identifier is 1861510240, issued on Mar 26, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Bountiful, UT. The record was last updated on Feb 25, 2021.