Provider Demographics
NPI:1801033196
Name:SAIN-CANARY, VALERIE LYNN (NP)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:LYNN
Last Name:SAIN-CANARY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:LYNN
Other - Last Name:SAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:ONE HURLEY PLAZA
Mailing Address - Street 2:SON, 5TH FLOOR
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-5993
Mailing Address - Country:US
Mailing Address - Phone:810-262-9353
Mailing Address - Fax:810-262-9509
Practice Address - Street 1:1 HURLEY PLZ
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-5902
Practice Address - Country:US
Practice Address - Phone:810-262-9773
Practice Address - Fax:810-262-9509
Is Sole Proprietor?:No
Enumeration Date:2009-01-08
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704222136363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OB51149OtherBLUE CROSS BLUE SHIELD OF MI
MION84570Medicare PIN
N84570024Medicare PIN