Provider Demographics
NPI:1326854183
Name:DOHERTY-STUART, VALERIE CHRISTINE
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:CHRISTINE
Last Name:DOHERTY-STUART
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 1:149 COMMON ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-1643
Mailing Address - Country:US
Mailing Address - Phone:617-680-7706
Mailing Address - Fax:
Practice Address - Street 1:149 COMMON ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-1643
Practice Address - Country:US
Practice Address - Phone:617-680-7706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2259478363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health