Provider Demographics
NPI:1184324089
Name:VALVERDE, CARMEN MANUELA (CLC, DOULA)
Entity type:Individual
Prefix:MRS
First Name:CARMEN
Middle Name:MANUELA
Last Name:VALVERDE
Suffix:
Gender:F
Credentials:CLC, DOULA
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 902
Mailing Address - Street 2:
Mailing Address - City:DODGE CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67801-0902
Mailing Address - Country:US
Mailing Address - Phone:620-253-7924
Mailing Address - Fax:
Practice Address - Street 1:10850 US HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:DODGE CITY
Practice Address - State:KS
Practice Address - Zip Code:67801-6538
Practice Address - Country:US
Practice Address - Phone:620-253-7924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSCVA-105063374J00000X
KSALPP-331740174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No374J00000XNursing Service Related ProvidersDoula