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General NPI Number Information
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NPI Number | 1619106374
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Entity Type | Individual
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Provider Name | DEBORAH CHARLENE WILLIS RRT
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Gender | Female
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Dates
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Enumeration Date | 07/02/2009
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Last Update Date | 04/30/2026
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Provider Practice Location Address
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Address Line | 3608 MARY ELIZABETH CHURCH RD
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City | WAXHAW
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State | NC
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Zip | 28173-9273
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Country | US
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Telephone | 704-534-0596
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Fax | 704-243-6119
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Provider Business Mailing Address
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Address Line | 3608 MARY ELIZABETH CHURCH RD
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City | WAXHAW
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State | NC
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Zip | 28173-9273
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Country | US
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Telephone | 704-534-0596
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Fax | 704-534-0596
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 227900000X
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Taxonomy Name | Registered Respiratory Therapist
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License Number | A-799
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License Number State | NC
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