Provider Demographics
NPI:1720189400
Name:C VALLIE CFNP LIMITED PARTNERSHIP
Entity Type:Organization
Organization Name:C VALLIE CFNP LIMITED PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:J
Authorized Official - Last Name:VALLIE
Authorized Official - Suffix:
Authorized Official - Credentials:CFNP
Authorized Official - Phone:432-699-6271
Mailing Address - Street 1:3423 CALDERA BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79705
Mailing Address - Country:US
Mailing Address - Phone:432-699-6271
Mailing Address - Fax:432-699-6296
Practice Address - Street 1:3423 CALDERA BLVD
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79707-2825
Practice Address - Country:US
Practice Address - Phone:432-699-6271
Practice Address - Fax:432-699-6296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX242554363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092873103Medicaid