Provider Demographics
NPI:1912925637
Name:EMERY, VALERIE BECKHAM (ANP)
Entity Type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:BECKHAM
Last Name:EMERY
Suffix:
Gender:F
Credentials:ANP
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 60352
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63160-0352
Mailing Address - Country:US
Mailing Address - Phone:314-362-1291
Mailing Address - Fax:314-454-8855
Practice Address - Street 1:3015 N BALLAS RD
Practice Address - Street 2:DIV IM CARDIOLOGY, STE 225
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2329
Practice Address - Country:US
Practice Address - Phone:314-362-1291
Practice Address - Fax:314-454-8855
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO089295363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO429088107Medicaid
MO821600183Medicaid
MOP00320475Medicare PIN
MOP00320475Medicare PIN