Provider Demographics
NPI:1366834434
Name:NUTTER, VALERIE RENEE (BACHELORS DEGREE)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:RENEE
Last Name:NUTTER
Suffix:
Gender:F
Credentials:BACHELORS DEGREE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6100 CHANNINGWAY BLVD STE 404
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-2938
Mailing Address - Country:US
Mailing Address - Phone:614-762-3738
Mailing Address - Fax:614-762-3530
Practice Address - Street 1:6100 CHANNINGWAY BLVD STE 404
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-2938
Practice Address - Country:US
Practice Address - Phone:614-762-3738
Practice Address - Fax:614-762-3530
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-26
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator