Basic Information
| Provider Information | |||||||||
| NPI: | 1689235947 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VELDHUIZEN | ||||||||
| FirstName: | MCKENZIE | ||||||||
| MiddleName: | JUSTINE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 S 7TH AVE | ||||||||
| Address2: | |||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571050998 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6055045400 | ||||||||
| FaxNumber: | 6055045150 | ||||||||
| Practice Location | |||||||||
| Address1: | 1035 S HIGHLINE PL | ||||||||
| Address2: | |||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571101000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053222925 | ||||||||
| FaxNumber: | 6053222926 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2019 | ||||||||
| LastUpdateDate: | 08/03/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 2019039419 | MO | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.