Individual
CHRISTOPHER EDISON VILLARRAGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-5754
(336) 716-6674
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-6674
(336) 716-9188
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5019062
NC
363L00000X
Nurse Practitioner
ARNP9361615
FL
363LG0600X
Gerontology Nurse Practitioner
APRN9361615
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105699600
—
FL
01
—
NND5J
BCBS
FL
Enumeration date
11/15/2018
Last updated
02/02/2024
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