Healthcare Provider Details

I. General information

NPI: 1346587813
Provider Name (Legal Business Name): RASHIDA R. WILLIS R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2013
Last Update Date: 01/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8168 N LEGARE CT APT 108
WEST CHESTER OH
45069-5142
US

IV. Provider business mailing address

8168 N LEGARE CT APT 108
WEST CHESTER OH
45069-5142
US

V. Phone/Fax

Practice location:
  • Phone: 513-212-5302
  • Fax:
Mailing address:
  • Phone: 513-212-5302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0400X
TaxonomyRehabilitation Registered Nurse
License Number382530
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: