MEDICARE: VALERIE RENEE NUTTER BACHELORS DEGREE

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
1	171M00000X	Case Manager/Care Coordinator		OH

General Provider Information

NPI Number	:	1366834434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE RENEE NUTTER BACHELORS DEGREE

Provider Business Mailing Address
First Line	:	6100 CHANNINGWAY BLVD STE 404
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-2938
Country	:	US
Telephone Number	:	614-762-3738
Fax Number	:	614-762-3530

Provider Business Practice Location Address
First Line	:	6100 CHANNINGWAY BLVD STE 404
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-2938
Country	:	US
Telephone Number	:	614-762-3738
Fax Number	:	614-762-3530

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2015
Last Update Date	:	06/01/2023

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