MEDICARE: MICHAEL SCOTLAND VALMORIA APRN

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	363LF0000X	Family Nurse Practitioner	TAPRN701136	NV

General Provider Information

NPI Number	:	1528446127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL SCOTLAND VALMORIA APRN

Provider Business Mailing Address
First Line	:	7 BIG SPRUCE LN
Second Line	:
City	:	WEST HAVEN
State	:	CT
Zip	:	06516-7711
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 BIG SPRUCE LN
Second Line	:
City	:	WEST HAVEN
State	:	CT
Zip	:	06516-7711
Country	:	US
Telephone Number	:	203-479-4493
Fax Number	:

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

Provider Enumeration Date	:	05/14/2015
Last Update Date	:	05/14/2015

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