Provider Demographics
NPI:1881070951
Name:DORRIAN, VALERIE (FNP)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:DORRIAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10151 DEERWOOD PARK BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-0566
Mailing Address - Country:US
Mailing Address - Phone:904-854-1545
Mailing Address - Fax:904-223-3149
Practice Address - Street 1:13460 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-0300
Practice Address - Country:US
Practice Address - Phone:843-763-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-30
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21010363LF0000X
CO0991719363LF0000X
FLAPRN9262091363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC21010OtherSC LICENSE
SCNP6371Medicaid
CO99771527Medicaid