Individual
NICHOLAS LEE VILLARREAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6401 FRANCE AVE S, EDINA, MN 55435-2104
(952) 924-5000
Mailing address
203 LITTLE JOHN LN, HAVELOCK, NC 28532-9554
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
5385
MN
Other
Enumeration date
08/21/2017
Last updated
03/17/2018
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