Provider Demographics
NPI:1083030191
Name:VALCOUR, RACHEAL A (NP)
Entity Type:Individual
Prefix:
First Name:RACHEAL
Middle Name:A
Last Name:VALCOUR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:RACHEAL
Other - Middle Name:A
Other - Last Name:KELLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1818 AMHERST ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2808
Mailing Address - Country:US
Mailing Address - Phone:540-450-0072
Mailing Address - Fax:
Practice Address - Street 1:125A MEDICAL CIR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3322
Practice Address - Country:US
Practice Address - Phone:540-667-1828
Practice Address - Fax:540-722-6207
Is Sole Proprietor?:No
Enumeration Date:2014-03-13
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024171590363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner