Provider Demographics
NPI:1164949673
Name:DEVILLE, VALERIE K (AGPCNP-C)
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:K
Last Name:DEVILLE
Suffix:
Gender:F
Credentials:AGPCNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 PARLIAMENT DR
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-5562
Mailing Address - Country:US
Mailing Address - Phone:318-426-6937
Mailing Address - Fax:
Practice Address - Street 1:6000 PARLIAMENT DR
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-5562
Practice Address - Country:US
Practice Address - Phone:318-426-6937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-25
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP09558363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty