Provider Demographics
NPI:1992762603
Name:VALENTINE, CHRISTY LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTY
Middle Name:LYNN
Last Name:VALENTINE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:145 LAPALCO BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-7149
Mailing Address - Country:US
Mailing Address - Phone:504-363-4711
Mailing Address - Fax:504-363-4741
Practice Address - Street 1:145 LAPALCO BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-7149
Practice Address - Country:US
Practice Address - Phone:504-363-4711
Practice Address - Fax:504-363-4741
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LAMD024974207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1424927Medicaid
LA4K858BC44Medicare PIN
I27303Medicare UPIN