Provider Demographics
NPI:1093791055
Name:VALENTA, CHRISTINE (A/GNP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:VALENTA
Suffix:
Gender:F
Credentials:A/GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1775 E SKYLINE DR
Mailing Address - Street 2:101
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-1162
Mailing Address - Country:US
Mailing Address - Phone:520-615-6200
Mailing Address - Fax:520-615-6255
Practice Address - Street 1:13101 N ORACLE RD
Practice Address - Street 2:169
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85739-9554
Practice Address - Country:US
Practice Address - Phone:520-825-0300
Practice Address - Fax:520-825-0047
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN051010363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Not Answered363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ543175Medicaid
AZ543175Medicaid
AZP00995Medicare UPIN
AZ64386Medicare ID - Type Unspecified