Provider Demographics
NPI:1427612472
Name:VILLA-MEALER, KATHRYN LORENA (RN)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:LORENA
Last Name:VILLA-MEALER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3634 ANDREA ST
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75604-1050
Mailing Address - Country:US
Mailing Address - Phone:956-225-6791
Mailing Address - Fax:
Practice Address - Street 1:3634 ANDREA ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75604-1050
Practice Address - Country:US
Practice Address - Phone:956-225-6791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-25
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX793845163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse