Healthcare Provider Details

I. General information

NPI: 1447264148
Provider Name (Legal Business Name): ELIZABETH ANNE VILLANI FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 03/25/2021
Certification Date: 03/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 SIX PINE RANCH RD
BATESVILLE IN
47006-1399
US

IV. Provider business mailing address

PO BOX 236
BATESVILLE IN
47006-0236
US

V. Phone/Fax

Practice location:
  • Phone: 812-934-5252
  • Fax: 812-932-0721
Mailing address:
  • Phone: 812-933-5441
  • Fax: 812-933-5446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71000295A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: