Lilibeth Villanueva Andrada, RN, CPNP

Individual provider Active NPI Registered Nurse · New Milford, NJ

NPI 1174749154 · NPPES record last updated Aug 2, 2007

Key facts

NPI
1174749154
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
4212561 (NY)
Practice address
597 Rhein CT
New Milford, NJ 07646-1030
Phone
(201) 384-8564
NPI assigned
Apr 18, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Certified Pediatric Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
4212561NYMDRegistered Nurse
F 381370-1NYMDPediatric Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X F 381370-1 NY
Registered Nurse 163W00000X 4212561 NY Yes

Addresses

Primary practice location

597 Rhein CT
New Milford, NJ 07646-1030

Mailing address

597 Rhein CT
New Milford, NJ 07646-1030
Phone (201) 384-8564

Other providers in New Milford, NJ

All providers in New Milford, NJ · Registered Nurse in New Jersey

Sources for this page

Verify at the official NPI Registry.