Provider Demographics
NPI:1861625063
Name:VILLANUEVA, DANIELA D (CNP)
Entity type:Individual
Prefix:
First Name:DANIELA
Middle Name:D
Last Name:VILLANUEVA
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:DANIELA
Other - Middle Name:
Other - Last Name:ROMO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 123
Mailing Address - Street 2:
Mailing Address - City:ANTON CHICO
Mailing Address - State:NM
Mailing Address - Zip Code:87711-0123
Mailing Address - Country:US
Mailing Address - Phone:575-512-8702
Mailing Address - Fax:
Practice Address - Street 1:1244 STATE HIGHWAY 386
Practice Address - Street 2:
Practice Address - City:ANTON CHICO
Practice Address - State:NM
Practice Address - Zip Code:87711-0123
Practice Address - Country:US
Practice Address - Phone:575-512-8702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-03
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM83927363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner