Provider Demographics
NPI:1730587965
Name:ROSS, VALENTINA (NURSES AIDE)
Entity type:Individual
Prefix:MISS
First Name:VALENTINA
Middle Name:
Last Name:ROSS
Suffix:
Gender:F
Credentials:NURSES AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:391 SWAMP RD
Mailing Address - Street 2:
Mailing Address - City:BEECH ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29842-4592
Mailing Address - Country:US
Mailing Address - Phone:803-634-1653
Mailing Address - Fax:
Practice Address - Street 1:391SWAMP R.D
Practice Address - Street 2:
Practice Address - City:BEECH ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29842
Practice Address - Country:US
Practice Address - Phone:803-634-1653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-22
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC119532E376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide