Basic Information
| Provider Information | |||||||||
| NPI: | 1366476392 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DICKERSON | ||||||||
| FirstName: | VALERIE | ||||||||
| MiddleName: | SHEPHARD | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 4540 | ||||||||
| Address2: | |||||||||
| City: | CARSON CITY | ||||||||
| State: | NV | ||||||||
| PostalCode: | 897024540 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7758820430 | ||||||||
| FaxNumber: | 7758526902 | ||||||||
| Practice Location | |||||||||
| Address1: | 925 IRONWOOD DR | ||||||||
| Address2: | SUITE 2102 | ||||||||
| City: | MINDEN | ||||||||
| State: | NV | ||||||||
| PostalCode: | 894235178 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7754457745 | ||||||||
| FaxNumber: | 7757820073 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2006 | ||||||||
| LastUpdateDate: | 10/23/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 8354 | NV | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.