Individual
JOHN DE VILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
902 LAKEVIEW AVE, PUEBLO, CO 81004-3597
(719) 557-5855
Mailing address
PO BOX 800022, KANSAS CITY, MO 64180-0022
(800) 953-0104
(720) 765-6640
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN.0995304-NP
CO
Other
Enumeration date
12/20/2019
Last updated
04/24/2020
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