Provider Demographics
NPI:1821508219
Name:ANDERSON, VALERIE (DNP, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3755
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68103-0755
Mailing Address - Country:US
Mailing Address - Phone:402-354-2100
Mailing Address - Fax:402-354-2155
Practice Address - Street 1:717 N 190TH PLZ STE 1100
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-3917
Practice Address - Country:US
Practice Address - Phone:402-815-1700
Practice Address - Fax:402-815-1959
Is Sole Proprietor?:No
Enumeration Date:2017-10-11
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE112348363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026480100Medicaid
NE47068731799Medicaid
NE10026301600Medicaid
IA1821508219Medicaid