Provider Demographics
NPI:1902090137
Name:MAGEE, VALENCIA FULLER
Entity Type:Individual
Prefix:MRS
First Name:VALENCIA
Middle Name:FULLER
Last Name:MAGEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 E RAILROAD ST
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-2942
Mailing Address - Country:US
Mailing Address - Phone:225-647-0580
Mailing Address - Fax:225-647-0580
Practice Address - Street 1:306 E RAILROAD ST
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-2942
Practice Address - Country:US
Practice Address - Phone:225-647-0580
Practice Address - Fax:225-647-0581
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7156253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care