Provider Demographics
NPI:1740338086
Name:VALENTINE, VIRGINIA (CNS)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:VALENTINE
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6100 PAN AMERICAN FREEWAY, NE
Mailing Address - Street 2:SUITE 390
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-3401
Mailing Address - Country:US
Mailing Address - Phone:505-823-1805
Mailing Address - Fax:505-823-1844
Practice Address - Street 1:6100 PAN AMERICAN FREEWAY, NE
Practice Address - Street 2:SUITE 390
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3401
Practice Address - Country:US
Practice Address - Phone:505-823-1805
Practice Address - Fax:505-823-1844
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR25515364SM0705X
NMCNS00087364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health
No364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-Surgical