Provider Demographics
NPI:1699707414
Name:VILLALON, LUZMARIA FERRERA (CNM)
Entity type:Individual
Prefix:
First Name:LUZMARIA
Middle Name:FERRERA
Last Name:VILLALON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 1/2 PEMBROKE RD
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811-2954
Mailing Address - Country:US
Mailing Address - Phone:203-791-5030
Mailing Address - Fax:
Practice Address - Street 1:33 1/2 PEMBROKE RD
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811-2954
Practice Address - Country:US
Practice Address - Phone:203-791-5030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000185367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife