Provider Demographics
NPI:1104039411
Name:BARRAMEDA, EDITHA SANDEE VALENCIA (RN, BSN)
Entity Type:Individual
Prefix:MRS
First Name:EDITHA SANDEE
Middle Name:VALENCIA
Last Name:BARRAMEDA
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5136 N NATOMA AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60656-3725
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4708 N CENTRAL AVE
Practice Address - Street 2:SUITE 1S
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-3210
Practice Address - Country:US
Practice Address - Phone:773-777-7815
Practice Address - Fax:773-777-7816
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health