Provider Demographics
NPI:1649579145
Name:VALLEY, KATIE J (FNP)
Entity Type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:J
Last Name:VALLEY
Suffix:
Gender:F
Credentials:FNP
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Mailing Address - Street 1:501 NEW KARNER RD
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-3882
Mailing Address - Country:US
Mailing Address - Phone:518-452-1337
Mailing Address - Fax:518-724-6660
Practice Address - Street 1:2125 RIVER RD
Practice Address - Street 2:SUITE 303
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12309-1135
Practice Address - Country:US
Practice Address - Phone:518-382-8350
Practice Address - Fax:518-382-0345
Is Sole Proprietor?:No
Enumeration Date:2011-03-23
Last Update Date:2014-08-29
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Provider Licenses
StateLicense IDTaxonomies
NY483595-1163W00000X
NYF337297-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03475849Medicaid
NY03475849Medicaid