Provider Demographics
NPI:1942962451
Name:VALENTINE, ANOLA M (LPN)
Entity Type:Individual
Prefix:MISS
First Name:ANOLA
Middle Name:M
Last Name:VALENTINE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2560 N LIMESTONE ST APT 212
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45503-1189
Mailing Address - Country:US
Mailing Address - Phone:937-926-6742
Mailing Address - Fax:
Practice Address - Street 1:2560 N LIMESTONE ST APT 212
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45503-1189
Practice Address - Country:US
Practice Address - Phone:937-926-6742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-12
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.136505.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse