Provider Demographics
NPI:1407235609
Name:VALENTINO, BRANDY MICHELLE (CNM)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:MICHELLE
Last Name:VALENTINO
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:BRANDY
Other - Middle Name:MICHELLE
Other - Last Name:KILGORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3501 N MACARTHUR BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-3675
Mailing Address - Country:US
Mailing Address - Phone:972-786-0140
Mailing Address - Fax:866-630-6348
Practice Address - Street 1:3501 N MACARTHUR BLVD STE 500
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-3675
Practice Address - Country:US
Practice Address - Phone:972-786-0140
Practice Address - Fax:866-630-6348
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-21
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128155367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife