Provider Demographics
NPI:1720362692
Name:PULSIPHER, VALERIE DIANNE (RN, BSN)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:DIANNE
Last Name:PULSIPHER
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2847 KELSO MESA DR
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81503
Mailing Address - Country:US
Mailing Address - Phone:970-623-4453
Mailing Address - Fax:
Practice Address - Street 1:2847 KELSO MESA DR
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81503-4213
Practice Address - Country:US
Practice Address - Phone:970-623-4453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO100006163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07100605Medicaid