Provider Demographics
NPI:1699333682
Name:VILLAHERMOSA, LALAINE (APRN FNP-C)
Entity type:Individual
Prefix:
First Name:LALAINE
Middle Name:
Last Name:VILLAHERMOSA
Suffix:
Gender:F
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:LALAINE
Other - Middle Name:ENSALADA
Other - Last Name:VILLAHERMOSA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN FNP-C
Mailing Address - Street 1:10155 W TWAIN AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-6722
Mailing Address - Country:US
Mailing Address - Phone:702-791-1400
Mailing Address - Fax:702-209-2830
Practice Address - Street 1:10155 W TWAIN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-6722
Practice Address - Country:US
Practice Address - Phone:702-791-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-04
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN46639163W00000X
NV839427363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse