JOHN DE VILLA (NPI# 1205474210) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205474210 |
| Entity Type | Individual |
| Full Name | JOHN DE VILLA |
| Credential | FNP-BC |
| Practice Address |
902 Lakeview Ave Pueblo CO 81004-3597 |
| Mailing Address |
Po Box 800022 Kansas City MO 64180-0022 |
| Practice Telephone | 7195575855 |
| Mailing Telephone | 8009530104 |
| Mailing Fax Number | 7207656640 |
| Enumeration Date | 2019-12-20 |
| Last Update Date | 2020-04-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APN.0995304-NP | CO | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1008 Minnequa Ave, Pueblo, CO 810043733 | 7195575855 |
| Street Address |
902 LAKEVIEW AVE |
| City | PUEBLO |
| State | CO |
| Zip Code | 81004-3597 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376549840 | Laura A Stein | Family Medicine | 902 Lakeview Ave, Pueblo, CO 81004 | 2005-06-21 |
| 1972114676 | Catholic Health Initiatives Colorado | Family Medicine | 902 Lakeview Ave, Pueblo, CO 81004-3597 | 2020-08-14 |
| 1275154668 | Alexander Thomas Grover | Family Medicine | 902 Lakeview Ave, Pueblo, CO 81004-3597 | 2020-04-27 |
| 1336769843 | Sydney Marie Brock | Family Medicine | 902 Lakeview Ave, Pueblo, CO 81004-3597 | 2020-04-24 |
| 1225658172 | Ashima Singh | Family Medicine | 902 Lakeview Ave, Pueblo, CO 81004-3597 | 2020-04-21 |
| 1467072249 | Joel Scott Bonzo | Family Medicine | 902 Lakeview Ave, Pueblo, CO 81004-3597 | 2020-04-21 |
| 1023638053 | Patrick Henke | Family Medicine | 902 Lakeview Ave, Pueblo, CO 81004-3597 | 2020-04-20 |
| 1659991917 | Kelsi Rae Brown | Family Medicine | 902 Lakeview Ave, Pueblo, CO 81004-3597 | 2020-04-16 |
| 1033773627 | Queenter Kisang | Family Medicine | 902 Lakeview Ave, Pueblo, CO 81004-3597 | 2019-04-29 |
| 1952964330 | Chad L Roberts | Family Medicine | 902 Lakeview Ave, Pueblo, CO 81004-3597 | 2019-04-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780155929 | Renee C Lane | Nurse Practitioner | 1925 E. Orman Ave. Ste. A109, Pueblo, CO 81004 | 2018-12-16 |
| 1215406913 | Kaiser Foundation Healthplan of Colorado | Pharmacy | 2625 W. Pueblo Blvd, Pueblo, CO 81004 | 2018-11-26 |
| 1053895532 | Rebecka Ann Reatherford | Nurse Practitioner | St Mary-corwin Medical Center, 1008 Minnequa Ave, Pueblo, CO 81004 | 2018-09-20 |
| 1124510821 | Angela M Sillas-green | Counselor | 327 Colorado Ave., Pueblo, CO 81004 | 2018-05-30 |
| 1558898569 | Alexandra R B King | Family Medicine | Southern Colorado Family Medicine, 902 Lakeview Avenue, Pueblo, CO 81004 | 2017-05-22 |
| 1578098752 | James Williams | Counselor | 414 Broadway Ave, Pueblo, CO 81004 | 2017-04-26 |
| 1740732601 | Valerie A Senger | Counselor | 635 W Corona Ave Ste 214, Pueblo, CO 81004 | 2016-10-26 |
| 1194111500 | A New Leaf Therapy, Pllc | Community/Behavioral Health | 327 Colorado Ave, Pueblo, CO 81004 | 2015-04-13 |
| 1619371671 | Mariah Mcginnis | Registered Nurse | 1232 Van Buren St., Pueblo, CO 81004 | 2014-10-20 |
| 1730593112 | Maritza Martinez | Registered Nurse | 1026 Wabriendo Ave, Pueblo, CO 81004 | 2014-06-13 |
| Find all providers in zip 81004 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932708872 | Carla E Paredes Diaz | Nurse Practitioner | 2215 South Dr, Pueblo, CO 81008-1755 | 2020-10-21 |
| 1902435506 | Brandi Lanae Trujillo | Nurse Practitioner | 3107 E Spaulding Ave Unit 202, Pueblo, CO 81008-5219 | 2020-04-06 |
| 1346883097 | Parkview Ancillary Services | Nurse Practitioner | 1600 N Grand Ave Ste 210, Pueblo, CO 81003-2749 | 2019-10-25 |
| 1326535618 | Amanda Michelle Meade | Nurse Practitioner | 201 Lamkin St Apt 101, Pueblo, CO 81003-3558 | 2018-04-23 |
| 1316456981 | Amy R Leibli | Nurse Practitioner | 1080 Chinook Lane, Pueblo, CO 81001 | 2017-09-26 |
| 1255865713 | Ideal Family Medicine, Ltd | Nurse Practitioner | 2016 S Pueblo Blvd, Pueblo, CO 81005-2546 | 2017-04-11 |
| 1154861995 | Jade Bryant | Nurse Practitioner | 1910 Lake Ave, Pueblo, CO 81004-3322 | 2017-02-27 |
| 1558811950 | Jane Graham | Nurse Practitioner | 1225 N Grand Ave, Pueblo, CO 81003-2845 | 2016-10-10 |
| 1124397559 | Michelle Leann Hartke | Nurse Practitioner | 1619 N Greenwood St Ste 208, Pueblo, CO 81003-2656 | 2011-12-14 |
| 1609008796 | Laura Ann Mcmahon | Nurse Practitioner | 4020 Jerry Murphy Rd/, Pueblo, CO 81001 | 2009-08-21 |
| Find all providers in PUEBLO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.