Healthcare Provider Details

I. General information

NPI: 1013272970
Provider Name (Legal Business Name): DEBORAH ELLEN VALENTINE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2012
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 FALCON RIDGE PKWY STE 201
MESQUITE NV
89027-8851
US

IV. Provider business mailing address

2370 CORPORATE CIR STE 300
HENDERSON NV
89074-7760
US

V. Phone/Fax

Practice location:
  • Phone: 702-979-5966
  • Fax:
Mailing address:
  • Phone: 702-910-3950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10028924
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number6995788-4405
License Number StateUT
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number887562
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: