Provider Demographics
NPI:1124281340
Name:MONTERREY, VALERIE ROSE (CPM)
Entity type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:ROSE
Last Name:MONTERREY
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 LONGACRE AVE
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-1552
Mailing Address - Country:US
Mailing Address - Phone:814-392-2277
Mailing Address - Fax:814-864-5183
Practice Address - Street 1:208 LONGACRE AVE
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-1552
Practice Address - Country:US
Practice Address - Phone:814-392-2277
Practice Address - Fax:814-864-5183
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-08
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06030015176B00000X
VA0129000072176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0129000072OtherCOMMONWEALTH OF VIRGINIA