Provider Demographics
NPI:1366006199
Name:VILLANUEVA, SONIA IVONNE (NP-C)
Entity Type:Individual
Prefix:MS
First Name:SONIA
Middle Name:IVONNE
Last Name:VILLANUEVA
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:449 E SILVER REEF RD
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-1521
Mailing Address - Country:US
Mailing Address - Phone:520-450-9155
Mailing Address - Fax:
Practice Address - Street 1:449 E SILVER REEF RD
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-1521
Practice Address - Country:US
Practice Address - Phone:520-450-9155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-26
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ222004363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily