Healthcare Provider Details

I. General information

NPI: 1861083305
Provider Name (Legal Business Name): VALERIE LEIGH CAIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VALERIE LEIGH NOLAND

II. Dates (important events)

Enumeration Date: 01/28/2021
Last Update Date: 07/24/2023
Certification Date: 07/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 ROOSEVELT BLVD
ELEANOR WV
25070-1390
US

IV. Provider business mailing address

97 GREAT TEAYS BLVD STE 6
SCOTT DEPOT WV
25560-9816
US

V. Phone/Fax

Practice location:
  • Phone: 304-586-0001
  • Fax:
Mailing address:
  • Phone: 304-757-6999
  • Fax: 304-201-5019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number107019
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: