Provider Demographics
NPI:1609211705
Name:VILLANI, DIANNE M (MA, FNP-C)
Entity Type:Individual
Prefix:MS
First Name:DIANNE
Middle Name:M
Last Name:VILLANI
Suffix:
Gender:F
Credentials:MA, 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:PO BOX 291943
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37229-1943
Mailing Address - Country:US
Mailing Address - Phone:802-434-3354
Mailing Address - Fax:
Practice Address - Street 1:20 W CANAL ST
Practice Address - Street 2:SUITE #C1
Practice Address - City:WINOOSKI
Practice Address - State:VT
Practice Address - Zip Code:05404-2131
Practice Address - Country:US
Practice Address - Phone:802-654-3562
Practice Address - Fax:802-654-3698
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-02
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101.0094572363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily