Provider Demographics
NPI:1548862485
Name:WILLIS, WENDY PARSONS (PHARMD)
Entity type:Individual
Prefix:DR
First Name:WENDY
Middle Name:PARSONS
Last Name:WILLIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 CORNERSTONE ST
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-5332
Mailing Address - Country:US
Mailing Address - Phone:434-489-8647
Mailing Address - Fax:
Practice Address - Street 1:3912 WARDS RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-2942
Practice Address - Country:US
Practice Address - Phone:434-237-7027
Practice Address - Fax:434-237-7924
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202204329183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist