MEDICARE: VALENCIA STAIR

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	163W00000X	Registered Nurse	RN.365844	OH

General Provider Information

NPI Number	:	1962767020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALENCIA STAIR

Provider Business Mailing Address
First Line	:	612 ADAMS ST
Second Line	:	PO BOX 18
City	:	CONESVILLE
State	:	OH
Zip	:	43811-7504
Country	:	US
Telephone Number	:	740-294-8950
Fax Number	:

Provider Business Practice Location Address
First Line	:	595 COUNTRY CLUB DR
Second Line	:
City	:	NEWARK
State	:	OH
Zip	:	43055-2154
Country	:	US
Telephone Number	:	740-294-8950
Fax Number	:

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

Provider Enumeration Date	:	07/05/2012
Last Update Date	:	09/18/2024

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Directions to “ VALENCIA STAIR ” Practice Location

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