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Individual

MARINA LEIGH VILLANUEVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
11 FARVIEW RD, WAYMART, PA 18472-7700
(570) 488-5811
Mailing address
1309 MOUNT COBB RD, JEFFERSON TWP, PA 18436-3215

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN746299
PA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP031987
PA

Other

Enumeration date
12/01/2023
Last updated
02/11/2025
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