Individual
MICHAEL BRYANNE VILLALBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
310 N STATE OF FRANKLIN RD STE 202, JOHNSON CITY, TN 37604-6063
(423) 929-7111
(423) 929-9448
Mailing address
310 N STATE OF FRANKLIN RD STE 202, JOHNSON CITY, TN 37604-6063
(423) 929-7111
(423) 929-9448
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
215795
TN
363L00000X
Nurse Practitioner
Primary
29178
TN
Other
Enumeration date
07/13/2020
Last updated
03/22/2021
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