Provider Demographics
NPI:1326038225
Name:VALERI, ANNE MARY (GNP-BC)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:MARY
Last Name:VALERI
Suffix:
Gender:F
Credentials:GNP-BC
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:MARY
Other - Last Name:O'MALLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:545A CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-2061
Mailing Address - Country:US
Mailing Address - Phone:617-754-0980
Mailing Address - Fax:617-754-0988
Practice Address - Street 1:545A CENTRE ST
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-2061
Practice Address - Country:US
Practice Address - Phone:617-754-0980
Practice Address - Fax:617-754-0988
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN184515363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0798851Medicaid
S18194Medicare UPIN
MA0798851Medicaid