Provider Demographics
NPI:1376228205
Name:VILLANUEVA-MEYERS, JOANNA MORTEGA (RN)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:MORTEGA
Last Name:VILLANUEVA-MEYERS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 AVENUE H UNIT 206
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-2629
Mailing Address - Country:US
Mailing Address - Phone:832-626-5124
Mailing Address - Fax:832-519-0038
Practice Address - Street 1:1919 AVENUE H UNIT 206
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-2629
Practice Address - Country:US
Practice Address - Phone:832-626-5124
Practice Address - Fax:832-519-0038
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX976743163W00000X
TX291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
No163W00000XNursing Service ProvidersRegistered Nurse