Provider Demographics
NPI:1093821811
Name:VILLIGER, MICHEL T (APRN)
Entity Type:Individual
Prefix:MRS
First Name:MICHEL
Middle Name:T
Last Name:VILLIGER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 W OLD MAIN ST
Mailing Address - Street 2:
Mailing Address - City:YELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72687-8284
Mailing Address - Country:US
Mailing Address - Phone:870-449-4221
Mailing Address - Fax:870-449-6777
Practice Address - Street 1:414 W OLD MAIN ST
Practice Address - Street 2:
Practice Address - City:YELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72687-8284
Practice Address - Country:US
Practice Address - Phone:870-449-4221
Practice Address - Fax:870-449-6777
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA02937363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5A033Medicare PIN