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General NPI Number Information
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NPI Number | 1164127379
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Entity Type | Individual
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Provider Name | LUCY VILLANUEVA PMHNP
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Gender | Female
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Dates
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Enumeration Date | 04/05/2023
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 16425 SPRING HILL DR
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City | BROOKSVILLE
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State | FL
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Zip | 34604-8167
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Country | US
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Telephone | 352-797-3769
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Fax |
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Provider Business Mailing Address
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Address Line | 3043 AMBASSADOR AVE
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City | SPRING HILL
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State | FL
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Zip | 34609-4510
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Country | US
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Telephone | 352-247-0078
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11025640
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License Number State | FL
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