Provider Demographics
NPI:1952410029
Name:VALUSEK, KATHLEEN JOY (C-NP)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:JOY
Last Name:VALUSEK
Suffix:
Gender:F
Credentials:C-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1364 CHATTERTON CT
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55123-1482
Mailing Address - Country:US
Mailing Address - Phone:651-687-0700
Mailing Address - Fax:651-454-3220
Practice Address - Street 1:1 VETERANS DR
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55417-2309
Practice Address - Country:US
Practice Address - Phone:612-476-1100
Practice Address - Fax:612-970-5892
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNR-119090-6363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner