Willis, Charlesetta

Willis, Charlesetta is an individual health care provider with primary practice located at 4145 Columbia Rd , Martinez GA 30907-5400. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Willis, Charlesetta can be contacted via phone (706) 869-7373.

Contact Information

Primary practice address
4145 Columbia Rd Martinez GA 30907-5400
Phone: (706) 869-7373
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X RN219487 Georgia
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1104575646
LBN Legal business name Willis, Charlesetta
Credentials MHA, MS, RN
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 22nd, 2022
Last updated Oct 13th, 2022 - about 4 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.

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