Provider Demographics
NPI:1730275348
Name:HOLCOMB, VALERIE JEANNE (APRN)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:JEANNE
Last Name:HOLCOMB
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 RIVER RD # C-25
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-3921
Mailing Address - Country:US
Mailing Address - Phone:860-704-4302
Mailing Address - Fax:860-704-4301
Practice Address - Street 1:915 RIVER RD # C-25
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-3921
Practice Address - Country:US
Practice Address - Phone:860-704-4302
Practice Address - Fax:860-704-4301
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000292363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OQ1956OtherHEALTH NET
209200OtherCONNECTICARE