Provider Demographics
NPI:1184462632
Name:MOUNTAIN VALLEY HEALTH CARE LLC
Entity type:Organization
Organization Name:MOUNTAIN VALLEY HEALTH CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DARMETKO
Authorized Official - Suffix:
Authorized Official - Credentials:DNP FNP PMHNP
Authorized Official - Phone:941-979-2327
Mailing Address - Street 1:1951 EVELYN BYRD AVE STE I
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3483
Mailing Address - Country:US
Mailing Address - Phone:826-444-6842
Mailing Address - Fax:844-691-1169
Practice Address - Street 1:1951 EVELYN BYRD AVE STE I
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3483
Practice Address - Country:US
Practice Address - Phone:826-444-6842
Practice Address - Fax:844-691-1169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-18
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty