Willis, Jodi
Willis, Jodi is an sole proprietor health care provider with primary practice located at 305 Wooley St , Raeford NC 28376-3236. She recently has only one registered license in Ambulatory Health Care Facilities / Developmental Disabilities, which is considered as her primary health care specialty. Willis, Jodi can be contacted via phone (910) 875-5074.Contact Information
Primary practice address
305 Wooley St
Raeford NC 28376-3236
Phone: (910) 875-5074
Fax: (910) 875-7694
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Developmental Disabilities | 261QD1600X |
Profile Details
| NPI number | 1912186792 |
|---|---|
| LBN Legal business name | Willis, Jodi |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 30th, 2007 |
| Last updated | Oct 30th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912186792 | NPPES |
| North Carolina | MEDICAID | 8300027K |
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