Individual
JENNIFER VILLANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
C/O SCI WAYMART, WAYMART, PA 18472
(570) 488-7220
Mailing address
300 CAMERON ST, SIMPSON, PA 18407-1104
(157) 028-1256
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
OA002118
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA
STATE CORRECTIONS INSURANCE
—
Enumeration date
10/16/2020
Last updated
10/16/2020
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