Healthcare Provider Details

I. General information

NPI: 1154245173
Provider Name (Legal Business Name): ADRIANA ROSENDO VILLA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3024 NEW BERN AVE
RALEIGH NC
27610-1247
US

IV. Provider business mailing address

1308 OPEN FIELD DR
GARNER NC
27529-6813
US

V. Phone/Fax

Practice location:
  • Phone: 919-231-9623
  • Fax:
Mailing address:
  • Phone: 919-800-1975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number5024844
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: