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General NPI Number Information
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NPI Number | 1851798896
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Entity Type | Individual
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Provider Name | DIANA E VILLARREAL RN, CPNP
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Gender | Female
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Dates
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Enumeration Date | 11/19/2014
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Last Update Date | 11/19/2014
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Provider Practice Location Address
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Address Line | 1616 LOGAN AVE
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City | LAREDO
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State | TX
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Zip | 78040-4647
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Country | US
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Telephone | 956-722-5162
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Fax | 956-722-0676
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Provider Business Mailing Address
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Address Line | 1616 LOGAN AVE
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City | LAREDO
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State | TX
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Zip | 78040-4647
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Country | US
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Telephone | 956-722-5162
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Fax | 956-722-0676
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | AP126931
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | AP126931
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 789378
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License Number State | TX
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