Individual
KEVIN VILLANUEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3695 HOT SPRINGS BLVD, LAS VEGAS, NM 87701-9549
(505) 454-2100
Mailing address
3695 HOT SPRINGS BLVD, LAS VEGAS, NM 87701-9549
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
96296
—
NM
Enumeration date
04/08/2026
Last updated
04/08/2026
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