Provider Demographics
NPI:1295705044
Name:KING, VALERIE L (ARNP)
Entity type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:L
Last Name:KING
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 1:505 NASHUA RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826-1929
Mailing Address - Country:US
Mailing Address - Phone:978-957-9650
Mailing Address - Fax:978-957-9017
Practice Address - Street 1:505 NASHUA RD
Practice Address - Street 2:SUITE 1
Practice Address - City:DRACUT
Practice Address - State:MA
Practice Address - Zip Code:01826-1929
Practice Address - Country:US
Practice Address - Phone:978-957-9650
Practice Address - Fax:978-957-9017
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA155406NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
70010000NP4082OtherBLUECROSS AND BLUE SHIELD
70010000NP4082OtherBLUECROSS AND BLUE SHIELD