Provider Demographics
NPI:1912549387
Name:VILLAVASO, CHLOE DAVIDSON (MN, APRN, ACNS-BC)
Entity Type:Individual
Prefix:MRS
First Name:CHLOE
Middle Name:DAVIDSON
Last Name:VILLAVASO
Suffix:
Gender:F
Credentials:MN, APRN, ACNS-BC
Other - Prefix:
Other - First Name:CHLOE
Other - Middle Name:CHERI
Other - Last Name:DAVIDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MN, RN
Mailing Address - Street 1:1430 TULANE AVE # 8548
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2632
Mailing Address - Country:US
Mailing Address - Phone:504-988-5152
Mailing Address - Fax:504-988-4237
Practice Address - Street 1:1430 TULANE AVE # 8548
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2632
Practice Address - Country:US
Practice Address - Phone:504-988-5152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-17
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA104894-06788364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health