Provider Demographics
NPI:1801849476
Name:SIRIANNI, VALERIE ROSE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:ROSE
Last Name:SIRIANNI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1749 PINE ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-3043
Mailing Address - Country:US
Mailing Address - Phone:325-696-0600
Mailing Address - Fax:325-676-3873
Practice Address - Street 1:1749 PINE ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-3043
Practice Address - Country:US
Practice Address - Phone:325-696-0600
Practice Address - Fax:325-676-3873
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR437363A00000X
TXPA10354363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX488831YP54Medicare PIN
Q73560Medicare UPIN