Provider Demographics
NPI:1003512286
Name:MCRAE, VALERIE REBECCA (FNP-C)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:REBECCA
Last Name:MCRAE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:REBECCA
Other - Last Name:SPRICKERHOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:105 WINDING WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-1348
Mailing Address - Country:US
Mailing Address - Phone:480-239-0447
Mailing Address - Fax:
Practice Address - Street 1:6439 GARNERS FERRY RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29209-1638
Practice Address - Country:US
Practice Address - Phone:803-776-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN.26878363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily