Provider Demographics
NPI:1336586726
Name:MATTHEWS, VALENCIA ANN (LPN)
Entity Type:Individual
Prefix:MS
First Name:VALENCIA
Middle Name:ANN
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4688 WALFORD RD
Mailing Address - Street 2:#11
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-7103
Mailing Address - Country:US
Mailing Address - Phone:216-256-8182
Mailing Address - Fax:
Practice Address - Street 1:4688 WALFORD RD
Practice Address - Street 2:#11
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-7103
Practice Address - Country:US
Practice Address - Phone:216-256-8182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-27
Last Update Date:2013-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN096740164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse