Provider Demographics
NPI:1073186847
Name:VILLEGAS, ALEXIS MARIE
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:MARIE
Last Name:VILLEGAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3085 HALLMARK CT STE 3
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-6803
Mailing Address - Country:US
Mailing Address - Phone:989-401-7600
Mailing Address - Fax:989-401-7607
Practice Address - Street 1:3085 HALLMARK CT STE 3
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-6803
Practice Address - Country:US
Practice Address - Phone:989-401-7600
Practice Address - Fax:989-401-7607
Is Sole Proprietor?:No
Enumeration Date:2021-07-20
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5303034305183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician