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Individual

VALERIE W. MATTINGLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
800 N FANT ST, ANDERSON, SC 29621-5708
(864) 512-1305
(864) 512-3790
Mailing address
800 N FANT ST, ANDERSON, SC 29621-5708
(864) 512-1305
(864) 512-3790

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3150
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
570359174
TAX ID
SC
Enumeration date
04/06/2007
Last updated
07/08/2007
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