Healthcare Provider Details

I. General information

NPI: 1124707716
Provider Name (Legal Business Name): SHEENA MARIE M VILLAROMAN APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2023
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4040 N MLK BLVD
NORTH LAS VEGAS NV
89032-3205
US

IV. Provider business mailing address

4040 N MLK BLVD
NORTH LAS VEGAS NV
89032-3205
US

V. Phone/Fax

Practice location:
  • Phone: 702-644-4673
  • Fax:
Mailing address:
  • Phone: 702-406-1061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number61446088
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number870858
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: