Provider Demographics
NPI:1992996771
Name:FLYNN, VALERIE
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:FLYNN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:
Other - Last Name:SCHULTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2400 S. MINNESOTA AVE.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-3762
Mailing Address - Country:US
Mailing Address - Phone:605-322-7510
Mailing Address - Fax:605-322-6475
Practice Address - Street 1:6701 S. MINNESOTA AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-2591
Practice Address - Country:US
Practice Address - Phone:605-322-6960
Practice Address - Fax:605-322-6961
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD8078207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P01090638OtherRR MEDICARE
SD5900000Medicaid
SD5900000Medicaid