Individual
MISS SHEILA LEE VILLALOBOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1700 N 103RD AVE APT 1076, AVONDALE, AZ 85392-4693
(623) 691-5815
(623) 691-5820
Mailing address
1700 N 103RD AVE APT 1076, AVONDALE, AZ 85392-4693
(623) 691-5815
(623) 691-5820
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP036816
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ITIN
—
AZ
Enumeration date
08/19/2016
Last updated
08/19/2016
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