Provider Demographics
NPI:1174636955
Name:VALENTINE-FJONE, CLAUDIA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:VALENTINE-FJONE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:CLAUDIA
Other - Middle Name:
Other - Last Name:VALENTINE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:2220 LEMP AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104-2700
Mailing Address - Country:US
Mailing Address - Phone:314-814-8680
Mailing Address - Fax:
Practice Address - Street 1:2220 LEMP AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-2700
Practice Address - Country:US
Practice Address - Phone:314-814-8680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO070828363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1174636955Medicaid
MO1174636955Medicaid
MO1174636955Medicare NSC