Provider Demographics
NPI:1659513547
Name:HALVERSON, VALERIE JOY (RPH)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:JOY
Last Name:HALVERSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4217 COX CT
Mailing Address - Street 2:APT B
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-8009
Mailing Address - Country:US
Mailing Address - Phone:307-220-0076
Mailing Address - Fax:
Practice Address - Street 1:4217 COX CT
Practice Address - Street 2:APT B
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-8009
Practice Address - Country:US
Practice Address - Phone:307-220-0076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 17947183500000X
ND3391183500000X
MN112475183500000X
HIPH 2609183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist