Provider Demographics
NPI:1598463119
Name:MILL, VALARIE CHRYSTAL (DNP)
Entity Type:Individual
Prefix:
First Name:VALARIE
Middle Name:CHRYSTAL
Last Name:MILL
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:VALARIE
Other - Middle Name:CHRYSTAL
Other - Last Name:BOONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1050 MILO CIR UNIT B
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-3294
Mailing Address - Country:US
Mailing Address - Phone:307-640-5801
Mailing Address - Fax:
Practice Address - Street 1:1639 SE ENSIGN LN # B103
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:OR
Practice Address - Zip Code:97146-7308
Practice Address - Country:US
Practice Address - Phone:503-338-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10004804363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily