Provider Demographics
NPI:1720792336
Name:MAC, VALERIE VI THIEN (APRN, ENP-C, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:VI THIEN
Last Name:MAC
Suffix:
Gender:F
Credentials:APRN, ENP-C, 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:PO BOX 1474
Mailing Address - Street 2:
Mailing Address - City:ST JOHN
Mailing Address - State:VI
Mailing Address - Zip Code:00831-1474
Mailing Address - Country:US
Mailing Address - Phone:770-712-8827
Mailing Address - Fax:
Practice Address - Street 1:1303 HOSPITAL GROUND STE 10
Practice Address - Street 2:
Practice Address - City:CHARLOTTE AMALIE
Practice Address - State:VI
Practice Address - Zip Code:00802-6722
Practice Address - Country:US
Practice Address - Phone:770-712-8827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VIAP14401P363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily