Provider Demographics
NPI:1407235609
Name:VALENTINO, BRANDY MICHELLE (CNM)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:MICHELLE
Last Name:VALENTINO
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:BRANDY
Other - Middle Name:MICHELLE
Other - Last Name:KILGORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3450 W WHEATLAND RD STE 440
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-4417
Mailing Address - Country:US
Mailing Address - Phone:972-298-4300
Mailing Address - Fax:972-298-8903
Practice Address - Street 1:3450 W WHEATLAND RD STE 440
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-4417
Practice Address - Country:US
Practice Address - Phone:972-298-4300
Practice Address - Fax:972-298-8903
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-21
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11034018363LW0102X
IAB181426363LW0102X
KY4024788363LW0102X
LA238231363LW0102X
OHAPRN.CNP.0036918363LW0102X
OK219861363LW0102X
KS53-83575-092367A00000X
TXAP128155367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health