1801066923 NPI number — DR. VALERIE W ACOSTA DNP FNPC FPMHNPBC

Table of content: DR. VALERIE W ACOSTA DNP FNPC FPMHNPBC (NPI 1801066923)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801066923 NPI number — DR. VALERIE W ACOSTA DNP FNPC FPMHNPBC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ACOSTA
Provider First Name:
VALERIE
Provider Middle Name:
W
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DNP FNPC FPMHNPBC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WOJDAC
Provider Other First Name:
VALERIE
Provider Other Middle Name:
W
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DNP FNPC FPMHNPBC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1801066923
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/07/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 13533
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EL PASO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79913-3533
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
915-241-4725
Provider Business Mailing Address Fax Number:
833-755-1174

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
224 ANTHONY DR
Provider Second Line Business Practice Location Address:
STE B
Provider Business Practice Location Address City Name:
ANTHONY
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
88021-9366
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
915-241-4725
Provider Business Practice Location Address Fax Number:
915-241-4725
Provider Enumeration Date:
03/04/2008

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: 363LF0000X , with the licence number:  608351 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: 608351 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: 67080 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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