Basic Information
Provider Information
NPI: 1366774424
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VALENT
FirstName: KEVIN
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5350 FRANTZ RD
Address2:  
City: DUBLIN
State: OH
PostalCode: 430164259
CountryCode: US
TelephoneNumber: 6145446155
FaxNumber: 6145446350
Practice Location
Address1: 111 S GRANT AVE
Address2: 3RD FL
City: COLUMBUS
State: OH
PostalCode: 432154701
CountryCode: US
TelephoneNumber: 6145669871
FaxNumber: 6145669503
Other Information
ProviderEnumerationDate: 02/01/2010
LastUpdateDate: 02/01/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X11318-NAOHY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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