Provider Demographics
NPI:1558089920
Name:VILLACHICA, AMY JEANETTE (APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:JEANETTE
Last Name:VILLACHICA
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4548 DAWN DR
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32583-9292
Mailing Address - Country:US
Mailing Address - Phone:850-510-0847
Mailing Address - Fax:
Practice Address - Street 1:4910 N 12TH AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8972
Practice Address - Country:US
Practice Address - Phone:850-494-4600
Practice Address - Fax:850-433-8940
Is Sole Proprietor?:No
Enumeration Date:2022-08-22
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11021227363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily