Provider Demographics
NPI:1841485232
Name:HENNESSY, VALERIE KAY (CNS)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:KAY
Last Name:HENNESSY
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6847 N CHESTNUT ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-3929
Mailing Address - Country:US
Mailing Address - Phone:330-296-4165
Mailing Address - Fax:330-296-5536
Practice Address - Street 1:6847 N CHESTNUT ST
Practice Address - Street 2:SUITE 300
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-3929
Practice Address - Country:US
Practice Address - Phone:330-296-4165
Practice Address - Fax:330-296-5536
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN212518163W00000X
PARN305148L163W00000X
OH2007005011364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No163W00000XNursing Service ProvidersRegistered Nurse