Provider Demographics
NPI:1891594800
Name:VALDEZ, MINERVA G
Entity type:Individual
Prefix:
First Name:MINERVA
Middle Name:G
Last Name:VALDEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1803 NIOBRARA AVE
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:NE
Mailing Address - Zip Code:69301-4420
Mailing Address - Country:US
Mailing Address - Phone:308-629-7397
Mailing Address - Fax:
Practice Address - Street 1:1803 NIOBRARA AVE
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:NE
Practice Address - Zip Code:69301-4420
Practice Address - Country:US
Practice Address - Phone:308-629-7397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant