Provider Demographics
NPI:1831542539
Name:ROSS, VALERIE KAE (PA-C)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:KAE
Last Name:ROSS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16681 185TH ST E
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:MN
Mailing Address - Zip Code:55033-9298
Mailing Address - Country:US
Mailing Address - Phone:651-734-5807
Mailing Address - Fax:
Practice Address - Street 1:16681 185TH ST E
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MN
Practice Address - Zip Code:55033-9298
Practice Address - Country:US
Practice Address - Phone:651-734-5807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant