Provider Demographics
NPI:1003414459
Name:UPSHAW, VALERIE LYNN (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:LYNN
Last Name:UPSHAW
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2421 WORTH ST
Mailing Address - Street 2:
Mailing Address - City:HEMPHILL
Mailing Address - State:TX
Mailing Address - Zip Code:75948-7215
Mailing Address - Country:US
Mailing Address - Phone:409-787-1416
Mailing Address - Fax:409-787-1419
Practice Address - Street 1:2421 WORTH ST
Practice Address - Street 2:
Practice Address - City:HEMPHILL
Practice Address - State:TX
Practice Address - Zip Code:75948-7215
Practice Address - Country:US
Practice Address - Phone:409-787-1416
Practice Address - Fax:409-787-1419
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-16
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0110555163W00000X
OK201702363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse