Provider Demographics
NPI:1629379409
Name:WILLIAMS, VALERIE DENISE (FNP)
Entity Type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:DENISE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3205 N ACADEMY BLVD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-5101
Mailing Address - Country:US
Mailing Address - Phone:719-632-5700
Mailing Address - Fax:719-344-7837
Practice Address - Street 1:3207 N ACADEMY BLVD
Practice Address - Street 2:STE 3100
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-5100
Practice Address - Country:US
Practice Address - Phone:719-632-5700
Practice Address - Fax:719-344-7821
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-09
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0010279-NP363LF0000X
CO10279363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO82153736Medicaid
CO82153736Medicaid