Provider Demographics
NPI:1427394766
Name:VILLANO, TERESA A (NP)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:A
Last Name:VILLANO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4677 TOWNE CENTRE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48604-2846
Mailing Address - Country:US
Mailing Address - Phone:989-790-0517
Mailing Address - Fax:989-790-0261
Practice Address - Street 1:4677 TOWNE CENTRE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-2846
Practice Address - Country:US
Practice Address - Phone:989-790-0517
Practice Address - Fax:989-790-0261
Is Sole Proprietor?:No
Enumeration Date:2012-12-13
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704149938363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner