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NPI Code Detail

MEDICARE: VALERIE LYNN UPSHAW APRN-CNP

MEDICARE: VALERIE LYNN UPSHAW APRN-CNP
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
1163W00000XRegistered NurseR0110555OK
2363LF0000XFamily Nurse Practitioner201702OK

General Provider Information

NPI Number : 1003414459
Entity Type Code : Individual
Provider Name (Legal Business Name) : VALERIE LYNN UPSHAW APRN-CNP
Provider Business Mailing Address
First Line : 2421 WORTH ST
Second Line :
City : HEMPHILL
State : TX
Zip : 75948-7215
Country : US
Telephone Number : 409-787-1416
Fax Number : 409-787-1419
Provider Business Practice Location Address
First Line : 2421 WORTH ST
Second Line :
City : HEMPHILL
State : TX
Zip : 75948-7215
Country : US
Telephone Number : 409-787-1416
Fax Number : 409-787-1419
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2020
Last Update Date : 05/03/2022

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