Provider Demographics
NPI:1295118602
Name:VILLANOVA, KIMBERLEE ANN (NNP-BC)
Entity type:Individual
Prefix:
First Name:KIMBERLEE
Middle Name:ANN
Last Name:VILLANOVA
Suffix:
Gender:F
Credentials:NNP-BC
Other - Prefix:
Other - First Name:KIMBERLEE
Other - Middle Name:ANN
Other - Last Name:RATTRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8412 EMERALD CIR
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-5776
Mailing Address - Country:US
Mailing Address - Phone:214-412-9940
Mailing Address - Fax:
Practice Address - Street 1:6621 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2358
Practice Address - Country:US
Practice Address - Phone:832-824-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-02
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP127687363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal