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NPI Code Detail

MEDICARE: VALERIE MBACKE FNP

MEDICARE: VALERIE MBACKE FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerCOA-17960-NPOH

General Provider Information

NPI Number : 1013387679
Entity Type Code : Individual
Provider Name (Legal Business Name) : VALERIE MBACKE FNP
Provider Business Mailing Address
First Line : 11509 RAPHAEL PL
Second Line :
City : CINCINNATI
State : OH
Zip : 45240-2015
Country : US
Telephone Number : 937-823-9658
Fax Number :
Provider Business Practice Location Address
First Line : 2170 ANDERSON FERRY RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45238-3328
Country : US
Telephone Number : 513-922-4271
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2015
Last Update Date : 05/17/2022

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