Provider Demographics
NPI:1649290081
Name:BURGELIN, VALERIE A (CFNP)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:A
Last Name:BURGELIN
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10641 WINDSMONT CT
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33936-7268
Mailing Address - Country:US
Mailing Address - Phone:239-258-1477
Mailing Address - Fax:844-442-8248
Practice Address - Street 1:1690 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-1155
Practice Address - Country:US
Practice Address - Phone:888-488-1258
Practice Address - Fax:844-442-8248
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMR53853363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM06375766Medicaid
NM06375766Medicaid
Q60379Medicare UPIN