Provider Demographics
NPI:1932430923
Name:GOULIAMIS, VALERIE D (CRNP)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:D
Last Name:GOULIAMIS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:D
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3400 SPRUCE ST
Mailing Address - Street 2:4 SILVERSTEIN
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4238
Mailing Address - Country:US
Mailing Address - Phone:215-662-3487
Mailing Address - Fax:215-349-5534
Practice Address - Street 1:3400 SPRUCE ST
Practice Address - Street 2:4 SILVERSTEIN
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4238
Practice Address - Country:US
Practice Address - Phone:215-662-3487
Practice Address - Fax:215-349-5534
Is Sole Proprietor?:No
Enumeration Date:2010-01-15
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010217363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care