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NPI Code Detail

MEDICARE: VALERIE FLYNN

MEDICARE: VALERIE FLYNN
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
1207N00000XDermatology Physician8078SD

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P01090638OTHERRR MEDICARE

Other Identifiers

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

General Provider Information

NPI Number : 1992996771
Entity Type Code : Individual
Provider Name (Legal Business Name) : VALERIE FLYNN
Provider Business Mailing Address
First Line : 2400 S. MINNESOTA AVE.
Second Line : SUITE 100
City : SIOUX FALLS
State : SD
Zip : 57105-3762
Country : US
Telephone Number : 605-322-7510
Fax Number : 605-322-6475
Provider Business Practice Location Address
First Line : 6701 S. MINNESOTA AVE
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57108-2591
Country : US
Telephone Number : 605-322-6960
Fax Number : 605-322-6961
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2007
Last Update Date : 12/06/2012

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Directions to “ VALERIE FLYNN ” Practice Location

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