Healthcare Provider Details

I. General information

NPI: 1417812843
Provider Name (Legal Business Name): MRS. BRITTANY RENEE VILLARREAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 VICTORY PARK DR
LINCOLN NE
68510-2484
US

IV. Provider business mailing address

420 VICTORY PARK DR
LINCOLN NE
68510-2484
US

V. Phone/Fax

Practice location:
  • Phone: 402-489-3802
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number14535
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: