Provider Demographics
NPI:1568094688
Name:VALENTINE, ANDREA KAY (DNP, CPNP, NP-C, RN)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:KAY
Last Name:VALENTINE
Suffix:
Gender:F
Credentials:DNP, CPNP, NP-C, RN
Other - Prefix:
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Mailing Address - Street 1:PO BOX 775383
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-5383
Mailing Address - Country:US
Mailing Address - Phone:812-376-5315
Mailing Address - Fax:812-375-3477
Practice Address - Street 1:2400 17TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-5351
Practice Address - Country:US
Practice Address - Phone:812-376-5974
Practice Address - Fax:812-375-3203
Is Sole Proprietor?:No
Enumeration Date:2020-02-06
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71009749A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily