IndividualActive
Deidra Willis, A- GNP
NPI 1114452901 · Primary Care Nurse Practitioner · Columbia, SC
Provider details
- NPI number
- 1114452901
- Entity type
- Individual
- Primary specialty
- Primary Care Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- A- GNP
- Sex
- Female
- Sole proprietor
- No
- License
- 20835 (SC)
Mailing address
160 Katrina Ct
Lexington, SC 29073-6924
Registry dates
- Enumerated
- 2017-04-29
- Last updated
- 2017-04-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.