Provider Demographics
NPI:1316129711
Name:VALENTIN, DENISE (RNP)
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:
Last Name:VALENTIN
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 FIANNA WAY
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72919-0001
Mailing Address - Country:US
Mailing Address - Phone:479-201-8515
Mailing Address - Fax:479-201-8503
Practice Address - Street 1:4020 NEWLON RD
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72904-2111
Practice Address - Country:US
Practice Address - Phone:479-201-8515
Practice Address - Fax:479-201-8503
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP00165363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARS12294Medicare UPIN