Provider Demographics
NPI:1316054398
Name:HULS, VALERIE L (DO)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:L
Last Name:HULS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:L
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13943 N 91ST AVE
Mailing Address - Street 2:C-101
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-3629
Mailing Address - Country:US
Mailing Address - Phone:623-760-9449
Mailing Address - Fax:623-974-9351
Practice Address - Street 1:14537 W INDIAN SCHOOL RD
Practice Address - Street 2:#700
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-9243
Practice Address - Country:US
Practice Address - Phone:623-935-0247
Practice Address - Fax:623-935-2209
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9022207N00000X
AZ005078207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ4Z2979OtherHEALTH NET
AZ99S007000015OtherMEDISUN
AZ608497Medicaid
AZ1316054398OtherBLUE CROSS BLUE SHIELD
AZ608497OtherAHCCCS
AZ9426203OtherAETNA
AZ2700764OtherUNITED HEALTHCARE
AZP00878147OtherRAILROAD MEDICARE
AZ608497Medicaid