Provider Demographics
NPI:1558642876
Name:ALBIN, VALERIE ANN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:ANN
Last Name:ALBIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:VALERIE
Other - Middle Name:ANN
Other - Last Name:SPISER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 8035
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-0035
Mailing Address - Country:US
Mailing Address - Phone:316-689-9135
Mailing Address - Fax:316-689-9667
Practice Address - Street 1:9211 E 21ST ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-2900
Practice Address - Country:US
Practice Address - Phone:316-609-4501
Practice Address - Fax:316-636-4076
Is Sole Proprietor?:No
Enumeration Date:2011-08-31
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-01480363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200740860BMedicaid