Most Relevant Information
Provider Data
| NPI Number: | 1003647603 |
| Provider Name: | DEANNA WILLIS |
| Entity Type: | Individual |
| Taxonomy Code: | 164X00000X |
| Specialty: | Licensed Vocational Nurse |
| License Number: | 337254 |
Most Important Dates
| Enumeration Date: | 08/13/2024 |
| Last Updated: | 08/13/2024 |
Provider Practice Location
449 E 2100 S
SALT LAKE CITY
UT
841152237
Practice Location Phone/Fax
| Phone: | 8015962111 |
| Fax: | 8013593878 |
Provider Mailing Location
449 E 2100 S
SALT LAKE CITY
UT
841152237
Provider Mailing Phone/Fax
| Phone: | 8015962111 |
| Fax: | 8013593878 |