Provider Demographics
NPI:1427508738
Name:BREEDING, VALERIE
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:BREEDING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:LEIGH
Other - Last Name:SIPPLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3403 BERKSHIRE CIR
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-8922
Mailing Address - Country:US
Mailing Address - Phone:423-440-9287
Mailing Address - Fax:
Practice Address - Street 1:890 RICHMOND PLZ
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2564
Practice Address - Country:US
Practice Address - Phone:859-623-5155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-11
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3010839363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily