Provider Demographics
NPI:1386830032
Name:MUMAW, VALERIE A (MSN CRNP)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:A
Last Name:MUMAW
Suffix:
Gender:F
Credentials:MSN CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 W HIGH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-5914
Mailing Address - Country:US
Mailing Address - Phone:419-996-5033
Mailing Address - Fax:419-996-5266
Practice Address - Street 1:770 W HIGH ST STE 300
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-5914
Practice Address - Country:US
Practice Address - Phone:419-996-5033
Practice Address - Fax:419-996-5266
Is Sole Proprietor?:No
Enumeration Date:2007-09-17
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHANPCNP09591363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3014802Medicaid
OHCOA-09591NPOtherNP
OHRN-314124-COA-1OtherRN
OHH132691Medicare PIN
OHCOA-09591NPOtherNP