Provider Demographics
NPI:1619259835
Name:VALLEE, MICHELE L (APRN)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:L
Last Name:VALLEE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-3418
Mailing Address - Country:US
Mailing Address - Phone:860-483-1074
Mailing Address - Fax:
Practice Address - Street 1:905 SOUTH MAIN ST
Practice Address - Street 2:CVS MINUTE CLINIC
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-3169
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004799363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily