Healthcare Provider Details

I. General information

NPI: 1154899219
Provider Name (Legal Business Name): SARAH MADELINE VILLAFRANCA RN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2018
Last Update Date: 11/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3460 WASHINGTON DR STE 200
EAGAN MN
55122-4302
US

IV. Provider business mailing address

2497 7TH AVE E STE 101
NORTH ST PAUL MN
55109-2946
US

V. Phone/Fax

Practice location:
  • Phone: 651-769-6200
  • Fax: 651-769-6249
Mailing address:
  • Phone: 651-769-6437
  • Fax: 651-769-6449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number2467821
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: