Provider Demographics
NPI:1851993265
Name:MARTINEZ, MICHELLE VILLARREAL (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:VILLARREAL
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 SPELLO CIR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-6879
Mailing Address - Country:US
Mailing Address - Phone:210-748-9466
Mailing Address - Fax:
Practice Address - Street 1:8550 HUEBNER RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1803
Practice Address - Country:US
Practice Address - Phone:210-379-1501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-10
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1019361363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily