Provider Demographics
NPI:1568648418
Name:O'MARA, VALORIE J (ANP)
Entity Type:Individual
Prefix:
First Name:VALORIE
Middle Name:J
Last Name:O'MARA
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 S WOODS MILL RD
Mailing Address - Street 2:SUITE 550
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3625
Mailing Address - Country:US
Mailing Address - Phone:314-434-3049
Mailing Address - Fax:314-205-6916
Practice Address - Street 1:222 S WOODS MILL RD
Practice Address - Street 2:SUITE 550
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3625
Practice Address - Country:US
Practice Address - Phone:314-434-3049
Practice Address - Fax:314-205-6916
Is Sole Proprietor?:No
Enumeration Date:2008-01-10
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO090290363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health