Provider Demographics
NPI:1265645345
Name:FLANNIGAN, VALERIE MARIE (STNA)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:MARIE
Last Name:FLANNIGAN
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 RUTH ELLEN DR
Mailing Address - Street 2:APT H 214
Mailing Address - City:RICHMOND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-1059
Mailing Address - Country:US
Mailing Address - Phone:216-731-4503
Mailing Address - Fax:
Practice Address - Street 1:120 RUTH ELLEN DR
Practice Address - Street 2:APT H 214
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44143-1059
Practice Address - Country:US
Practice Address - Phone:216-731-4503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2310672374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2310672OtherPROVIDER NUMBER