Provider Demographics
NPI:1720618630
Name:MANLEY, VALERIE GABRIELLE (FNP-C)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:GABRIELLE
Last Name:MANLEY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1552 HUNT RD SE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37323-8860
Mailing Address - Country:US
Mailing Address - Phone:423-223-9188
Mailing Address - Fax:
Practice Address - Street 1:1552 HUNT RD SE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37323-8860
Practice Address - Country:US
Practice Address - Phone:423-223-9188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-20
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA291807363LF0000X
TN26116363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily