Provider Demographics
NPI:1588620348
Name:MALVEAUX, VALENCIA MARIA (NP)
Entity Type:Individual
Prefix:
First Name:VALENCIA
Middle Name:MARIA
Last Name:MALVEAUX
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3720 PRYTANIA ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3733
Mailing Address - Country:US
Mailing Address - Phone:504-891-3711
Mailing Address - Fax:504-891-6353
Practice Address - Street 1:3720 PRYTANIA ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3733
Practice Address - Country:US
Practice Address - Phone:504-891-3711
Practice Address - Fax:504-891-6353
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-21
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN069856 AP03363363LA2100X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA500017835OtherRAILROAD PROVIDER #
LA1439908Medicaid
LA733863950003OtherCIGNA
LA5X718Medicare ID - Type Unspecified
LA733863950003OtherCIGNA