Provider Demographics
NPI:1407804800
Name:MALLOY, VALERIE JUNE (DO)
Entity Type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:JUNE
Last Name:MALLOY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:VALERIE
Other - Middle Name:JUNE
Other - Last Name:VOTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:305 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-2305
Mailing Address - Country:US
Mailing Address - Phone:602-692-9191
Mailing Address - Fax:
Practice Address - Street 1:OFFUTT AFB
Practice Address - Street 2:ERHLING BERQUIST CLINIC
Practice Address - City:BELLUVUE
Practice Address - State:NE
Practice Address - Zip Code:68113
Practice Address - Country:US
Practice Address - Phone:402-294-9331
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3958207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine