Provider Demographics
NPI:1164000790
Name:VALENTON, MELLYCAR CANAPE (APRN FNP-BC)
Entity Type:Individual
Prefix:
First Name:MELLYCAR
Middle Name:CANAPE
Last Name:VALENTON
Suffix:
Gender:F
Credentials:APRN FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 GREENWICH AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-2526
Mailing Address - Country:US
Mailing Address - Phone:203-278-1960
Mailing Address - Fax:
Practice Address - Street 1:347 GREENWICH AVE STE 3
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-2526
Practice Address - Country:US
Practice Address - Phone:203-278-1960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-02
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9604363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily