Provider Demographics
NPI:1093472458
Name:AVALLONE, VALERIE MARIE (FNP-C)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:MARIE
Last Name:AVALLONE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4150 DEP BILL CANTRELL MEMORIAL RD STE 290
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-3002
Mailing Address - Country:US
Mailing Address - Phone:404-446-0600
Mailing Address - Fax:404-446-0601
Practice Address - Street 1:4150 DEP BILL CANTRELL MEMORIAL RD STE 290
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-3002
Practice Address - Country:US
Practice Address - Phone:404-446-0600
Practice Address - Fax:404-446-0601
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN306499363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily