Provider Demographics
NPI:1942386941
Name:ROE, VALERIE ANN (CNM, LM)
Entity Type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:ANN
Last Name:ROE
Suffix:
Gender:F
Credentials:CNM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1945 PARK ST
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11509-1342
Mailing Address - Country:US
Mailing Address - Phone:718-270-7755
Mailing Address - Fax:
Practice Address - Street 1:450 CLARKSON AVE; SUNY DOWNSTATE MEDICAL CENTER
Practice Address - Street 2:BOX 1227 MIDWIFERY EDUCATION PROGRAM
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203
Practice Address - Country:US
Practice Address - Phone:718-270-7755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF000245367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife