Provider Demographics
NPI:1881032167
Name:VILLARREAL, HEATHER HOUSE (CRNA, ARNP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:HOUSE
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:CRNA, ARNP
Other - Prefix:MRS
Other - First Name:HEATHER
Other - Middle Name:RENE
Other - Last Name:HOUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9099 GRAPHITE CIR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-5227
Mailing Address - Country:US
Mailing Address - Phone:864-320-5256
Mailing Address - Fax:
Practice Address - Street 1:9099 GRAPHITE CIR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34120-5227
Practice Address - Country:US
Practice Address - Phone:864-320-5256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-10
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22409367500000X
FL9300686367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered