La Shanda D Willis, MA
Nurse's Aide in Cleveland, OH. Individual provider (NPI-1).
NPI number1104530351
StatusActive
Last updated in NPPESJan 12, 2023
Details
- NPI
- 1104530351
- Entity type
- Individual (NPI-1)
- Name
- La Shanda D Willis
- Credential
- MA
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 12, 2023
- Certification date
- Jan 18, 2022
- Last updated
- Jan 12, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 376K00000X | Nurse's Aide | – | – | Yes |
Practice location
3388 E 121st StCleveland, OH 44120-4302
Phone 216-526-3036
Mailing address
3388 E 121st StCleveland, OH 44120-4302
Phone 216-526-3036
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