Provider Demographics
NPI:1265980668
Name:WOLD, VALERIE R (ARNP)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:R
Last Name:WOLD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3385 DEXTER CT
Mailing Address - Street 2:STE 300
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-3471
Mailing Address - Country:US
Mailing Address - Phone:563-344-9292
Mailing Address - Fax:563-344-9573
Practice Address - Street 1:3385 DEXTER CT
Practice Address - Street 2:SUITE 301
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-3494
Practice Address - Country:US
Practice Address - Phone:563-344-9292
Practice Address - Fax:563-344-9573
Is Sole Proprietor?:No
Enumeration Date:2016-09-14
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61170327363LG0600X
IAH129522363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology