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NPI 1639003486

NPI 1639003486 : VILLA AESTHETICS & WELLNESS : WATERLOO, IL

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General NPI Number Information
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    NPI Number           |    1639003486
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    Entity Type          |    Organization 
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    Legal Business Name  |    VILLA AESTHETICS & WELLNESS 
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Dates
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    Enumeration Date     |    06/09/2026
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    Last Update Date     |    06/09/2026
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Provider Practice Location Address
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    Address Line         |    906 TAYLOR DR 
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    City                 |    WATERLOO
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    State                |    IL
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    Zip                  |    62298-1152
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    Country              |    US
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    Telephone            |    314-602-0752
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    906 TAYLOR DR 
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    City                 |    WATERLOO
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    State                |    IL
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    Zip                  |    62298-1152
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    Country              |    US
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    Telephone            |    314-602-0752
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER/ NURSE PRACTITIONER
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    Name                 |     ERIN  DRINEN 
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    Credential           |    NP-FPA
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    Telephone            |    314-602-0752
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QP2300X
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    Taxonomy Name        |    Primary Care Clinic/Center
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    License Number       |    
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    License Number State |    
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