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NPI Code Detail

MEDICARE: AMANDA ROCHELLE VILLA

MEDICARE: AMANDA ROCHELLE VILLA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist20001NV

General Provider Information

NPI Number : 1821571589
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA ROCHELLE VILLA
Provider Business Mailing Address
First Line : 4470 E BONANZA RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110-6330
Country : US
Telephone Number : 702-531-8006
Fax Number : 702-531-8013
Provider Business Practice Location Address
First Line : 4470 E BONANZA RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110-6330
Country : US
Telephone Number : 702-531-8006
Fax Number : 702-531-8013
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2018
Last Update Date : 09/10/2018

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Directions to “ AMANDA ROCHELLE VILLA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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