Provider Demographics
NPI:1003200619
Name:VALENZUELA, ORLANDO SANTIAGO JR (AGNP-C)
Entity Type:Individual
Prefix:MR
First Name:ORLANDO
Middle Name:SANTIAGO
Last Name:VALENZUELA
Suffix:JR
Gender:M
Credentials:AGNP-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4006 LONGBOW CT
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:27282-7710
Mailing Address - Country:US
Mailing Address - Phone:336-317-5348
Mailing Address - Fax:
Practice Address - Street 1:350 N COX ST STE 6
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-5514
Practice Address - Country:US
Practice Address - Phone:336-629-2201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-20
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5007542363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner