Provider Demographics
NPI:1174798698
Name:VILLA, NANCY H (MED, CCC-A)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:H
Last Name:VILLA
Suffix:
Gender:F
Credentials:MED, CCC-A
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:H
Other - Last Name:HEUMANN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MED, CCC-A
Mailing Address - Street 1:985 ROBERT BLVD
Mailing Address - Street 2:STE. 104
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-2063
Mailing Address - Country:US
Mailing Address - Phone:985-847-1995
Mailing Address - Fax:985-847-1992
Practice Address - Street 1:985 ROBERT BLVD
Practice Address - Street 2:STE. 104
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-2063
Practice Address - Country:US
Practice Address - Phone:985-847-1995
Practice Address - Fax:985-847-1992
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3131237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter