Provider Demographics
NPI:1194272278
Name:VALBRUN, JOSELLANDE
Entity type:Individual
Prefix:
First Name:JOSELLANDE
Middle Name:
Last Name:VALBRUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOMBARD
Mailing Address - Street 2:
Mailing Address - City:PORT DE PAIX
Mailing Address - State:PORT DE PAIX
Mailing Address - Zip Code:4003
Mailing Address - Country:GF
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1234 BOMBARD
Practice Address - Street 2:
Practice Address - City:PORT DE PAIX
Practice Address - State:PORT DE PAIX
Practice Address - Zip Code:4003
Practice Address - Country:GF
Practice Address - Phone:009-000-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other