Individual
LAURA A VILLANUEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
130 E VIRGINIA AVE, GUNNISON, CO 81230-2246
(970) 641-0211
(970) 641-1268
Mailing address
130 E VIRGINIA AVE, GUNNISON, CO 81230-2246
(970) 641-0211
(970) 641-1268
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
55781
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95300040
—
CO
Enumeration date
05/31/2011
Last updated
08/26/2021
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