Provider Demographics
NPI:1679148241
Name:DENNIS, VALERIE LYNNE (AG-ACNP)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:LYNNE
Last Name:DENNIS
Suffix:
Gender:F
Credentials:AG-ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8201 EWING HALSELL DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3707
Mailing Address - Country:US
Mailing Address - Phone:210-575-4837
Mailing Address - Fax:210-575-8647
Practice Address - Street 1:8201 EWING HALSELL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3707
Practice Address - Country:US
Practice Address - Phone:210-575-4837
Practice Address - Fax:210-575-8647
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1019993363LA2100X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1019993OtherTEXAS BOARD OF NURSING
TX2020114482OtherABSNC
TX812133OtherTEXAS BOARD OF NURSING