Individual
IAN VILLANUEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNP, FNP-BC
Contact information
Practice address
1900 WARDENBURG DRIVE, BOULDER, CO 80309-1508
(314) 499-8625
Mailing address
1312 17TH ST # 991, DENVER, CO 80202-1508
(314) 499-8625
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0996133-NP
CO
Other
Enumeration date
12/31/2020
Last updated
12/31/2020
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