Provider Demographics
NPI:1174993521
Name:HALLOWELL, VALERIE (FNP)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:HALLOWELL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1118 SANDPIPER LN
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-9180
Mailing Address - Country:US
Mailing Address - Phone:317-408-5969
Mailing Address - Fax:
Practice Address - Street 1:27386 CARRONADE DR
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-3368
Practice Address - Country:US
Practice Address - Phone:567-336-4662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-29
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71005738A363LF0000X
OHAPRN.CNP.025881363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily