Provider Demographics
NPI:1013553536
Name:LOUIS, VALERIE WITLINE (RN)
Entity Type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:WITLINE
Last Name:LOUIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:VALERIE
Other - Middle Name:WITLINE
Other - Last Name:LOUIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:9 W MILTON ST
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:MA
Mailing Address - Zip Code:02136-1921
Mailing Address - Country:US
Mailing Address - Phone:508-808-8255
Mailing Address - Fax:
Practice Address - Street 1:9 W MILTON ST
Practice Address - Street 2:
Practice Address - City:HYDE PARK
Practice Address - State:MA
Practice Address - Zip Code:02136-1921
Practice Address - Country:US
Practice Address - Phone:508-808-8255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-19
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2290129163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAS14263895OtherDRIVER'S LICENSE