Provider Demographics
NPI:1265072888
Name:VALDIVIA, NANCHESCA (APRN)
Entity type:Individual
Prefix:MS
First Name:NANCHESCA
Middle Name:
Last Name:VALDIVIA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10347 OLDE CLYDESDALE CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33449-4600
Mailing Address - Country:US
Mailing Address - Phone:561-676-1703
Mailing Address - Fax:
Practice Address - Street 1:10131 FOREST HILL BLVD STE 140
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-6155
Practice Address - Country:US
Practice Address - Phone:561-513-9030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-11
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11002875363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily