Individual provider · Type 1 NPI
Ma Cornelia Villavicencio Leano, NURSE PRACTITIONER
Gerontology Nurse Practitioner · Fayetteville, NC
NPI number
1780179580
Active
Practice location
3081 Stone Carriage Cir Apt Z
Fayetteville, NC 28304
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | LEAN-18CO92 (NC) |
| Gerontology Nurse Practitioner Primary | 363LG0600X | LEAN-18CO92 (NC) |
Gerontology Nurse Practitioner: Definition to come...
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About NPI 1780179580
Ma Cornelia Villavicencio Leano, NURSE PRACTITIONER's National Provider Identifier is 1780179580, issued on Jun 25, 2018. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Fayetteville, NC. The record was last updated on Jul 11, 2018.