Provider Demographics
NPI:1790439578
Name:VILLELLA, JULIANNA (RN)
Entity Type:Individual
Prefix:
First Name:JULIANNA
Middle Name:
Last Name:VILLELLA
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 1:14634 SEEDLING DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48094-3245
Mailing Address - Country:US
Mailing Address - Phone:586-610-4840
Mailing Address - Fax:
Practice Address - Street 1:14634 SEEDLING DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MI
Practice Address - Zip Code:48094-3245
Practice Address - Country:US
Practice Address - Phone:586-610-4840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704342835163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty