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1568456846

NPI Code Detail

MEDICARE: VALERIE HEARNS MD

MEDICARE: VALERIE HEARNS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	3539	SD
2	207Q00000X	Family Medicine Physician	25MA04869600	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568456846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE HEARNS MD

Provider Business Mailing Address
First Line	:	PO BOX 5074
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57117-5074
Country	:	US
Telephone Number	:	605-328-0020
Fax Number	:	605-328-0021

Provider Business Practice Location Address
First Line	:	2701 S KIWANIS AVE
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57105-4252
Country	:	US
Telephone Number	:	605-328-0020
Fax Number	:	605-328-0021

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2005
Last Update Date	:	12/16/2014

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Directions to “ VALERIE HEARNS MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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