Provider Demographics
NPI:1588396931
Name:VALERIE, MICHELLE MARIA (REGISTERED NURSE)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:MARIA
Last Name:VALERIE
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18301 144TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11413-3207
Mailing Address - Country:US
Mailing Address - Phone:347-446-7180
Mailing Address - Fax:
Practice Address - Street 1:18301 144TH AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11413-3207
Practice Address - Country:US
Practice Address - Phone:347-446-7180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-25
Last Update Date:2022-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY468313163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical