Provider Demographics
NPI:1396440491
Name:VILLEGAS, KRYSTAL ELAINE (APRN, MSN, PMHNP)
Entity type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:ELAINE
Last Name:VILLEGAS
Suffix:
Gender:F
Credentials:APRN, MSN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7466 SMUGGLERS GULCH CT
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79911-2230
Mailing Address - Country:US
Mailing Address - Phone:520-334-7006
Mailing Address - Fax:
Practice Address - Street 1:7466 SMUGGLERS GULCH CT
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79911-2230
Practice Address - Country:US
Practice Address - Phone:520-334-7006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM72429363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health