Provider Demographics
NPI:1447220207
Name:GUERNSEY, VALERIE D (DO)
Entity Type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:D
Last Name:GUERNSEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2187 N VICKEY ST
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86004-6106
Mailing Address - Country:US
Mailing Address - Phone:928-527-1899
Mailing Address - Fax:
Practice Address - Street 1:2695 E INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86004-6109
Practice Address - Country:US
Practice Address - Phone:928-527-1899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI51010095122084P0800X
AZ45692084P0800X
CA20A 123422084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI26OC31041OtherBCBS PROVIDER
MI136589000OtherMAGELLAN PROVIDER
MI4339994OtherAETNA PROVIDER
MI26OC31041OtherBCBS PROVIDER
MIE49683Medicare UPIN