Individual
RENATE A VILLARREAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3801 SPRING ST, RACINE, WI 53405-1667
(262) 687-4479
(262) 687-5375
Mailing address
3805B SPRING ST, SUITE 230, RACINE, WI 53405-1641
(262) 687-4479
(262) 687-5375
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2600-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2600-23
WI LICENSE
WI
Enumeration date
08/11/2010
Last updated
07/28/2022
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