Provider Demographics
NPI:1740707991
Name:VILLAR, VERNESSA R
Entity type:Individual
Prefix:
First Name:VERNESSA
Middle Name:R
Last Name:VILLAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2760 S ROBERTSON RD
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82604-3673
Mailing Address - Country:US
Mailing Address - Phone:307-337-7277
Mailing Address - Fax:
Practice Address - Street 1:2760 S ROBERTSON RD
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82604-3673
Practice Address - Country:US
Practice Address - Phone:307-337-7277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant