1316054398 NPI number — VALERIE L HULS DO

Table of content: VALERIE L HULS DO (NPI 1316054398)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316054398 NPI number — VALERIE L HULS DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HULS
Provider First Name:
VALERIE
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
JOHNSON
Provider Other First Name:
VALERIE
Provider Other Middle Name:
L
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1316054398
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/26/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13943 N 91ST AVE
Provider Second Line Business Mailing Address:
C-101
Provider Business Mailing Address City Name:
PEORIA
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85381-3629
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
623-760-9449
Provider Business Mailing Address Fax Number:
623-974-9351

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14537 W INDIAN SCHOOL RD
Provider Second Line Business Practice Location Address:
#700
Provider Business Practice Location Address City Name:
GOODYEAR
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85395-9243
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
623-935-0247
Provider Business Practice Location Address Fax Number:
623-935-2209
Provider Enumeration Date:
08/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207N00000X , with the licence number:  OS9022 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207N00000X , with the licence number: 005078 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4Z2979 . This is a "HEALTH NET" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 99S007000015 . This is a "MEDISUN" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 608497 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1316054398 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 608497 . This is a "AHCCCS" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 9426203 . This is a "AETNA" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 2700764 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: P00878147 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com