NPI 1316670631

Nishae Latrice Willis, CNA

Practitioner Driver Saint Louis, MO

Practice location

Address: 7315 Albright Ave, Saint Louis, MO 63136-1228
Phone: (314) 699-1166

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence V137105002 (MO)

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Registry record

NPI: 1316670631
Entity type: Individual
Sex (as registered): Female
NPI issued: 5 Jul 2022
Record last updated: 5 Jul 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.