| Doctor Name: | MICHELLE L WILLIS |
| NPI Number: | 1922305051 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ANP |
| License Number: | A03492 |
| Business Practice Address: | 25 Business Park Dr Greenbrier, AR - 720589263 |
| Business Phone Number: | 5016793998 |
| Business Fax Number: | 5017082538 |
| Mailing Address: | Po Box 177, GREENBRIER |
| State: | AR |
| Postal Code: | 720580177 |
| Phone Number: | 5016793998 |
| Fax Number: | 5017082538 |
| NPI Enumeration Date: | 02/25/2011 |
| NPI Last Update Date: | 04/04/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | A03492 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |