1235226119 NPI number — MS. MELENNA JANE VALLIERE RN

Table of content: MS. MELENNA JANE VALLIERE RN (NPI 1235226119)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235226119 NPI number — MS. MELENNA JANE VALLIERE RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VALLIERE
Provider First Name:
MELENNA
Provider Middle Name:
JANE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
RN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CROMPTON
Provider Other First Name:
MELENNA
Provider Other Middle Name:
JANE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1235226119
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CMR 416
Provider Second Line Business Mailing Address:
BOX 280
Provider Business Mailing Address City Name:
APO
Provider Business Mailing Address State Name:
AE
Provider Business Mailing Address Postal Code:
09140
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
011499841
Provider Business Mailing Address Fax Number:
834834

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
USAMEDDAC WUERZBURG
Provider Second Line Business Practice Location Address:
ILLESHEIM CLINIC
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AE
Provider Business Practice Location Address Postal Code:
09140
Provider Business Practice Location Address Country Code:
DE
Provider Business Practice Location Address Telephone Number:
011499841
Provider Business Practice Location Address Fax Number:
834834
Provider Enumeration Date:
10/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  RN 084394 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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