Most Relevant Information
Provider Data
| NPI Number: | 1003035148 |
| Provider Name: | MARY ELIZABETH O'BOYLE WILLIS FNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 0024167014 |
Most Important Dates
| Enumeration Date: | 04/25/2007 |
| Last Updated: | 04/05/2017 |
Provider Practice Location
1250 E MARSHALL ST
DEPARTMENT OF PEDIATRICS
RICHMOND
VA
232985051
Practice Location Phone/Fax
| Phone: | 8046280189 |
| Fax: | 8048286301 |
Provider Mailing Location
PO BOX 91734
RICHMOND
VA
232911734
Provider Mailing Phone/Fax
| Phone: | 8043586100 |
| Fax: | 8043427619 |