Valle, Jetta

Valle, Jetta is an individual health care provider with primary practice located at 1705 W Main St , Mesa AZ 85201. She recently has 4 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Primary Care, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Addiction Medicine is her primary health care specialty. Valle, Jetta can be contacted via phone (877) 809-5092.

Contact Information

Primary practice address
1705 W Main St Mesa AZ 85201
Phone: (877) 809-5092
Fax: (480) 718-9477
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 66001 West Virginia
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 3007628 Kentucky
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X AP10652 Arizona
Allopathic & Osteopathic Physicians / Addiction Medicine 207QA0401X AP10652 Arizona

Profile Details

NPI number 1720336910
LBN Legal business name Valle, Jetta
Credentials MSN, PMHNP-BC, FNP-B
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 21st, 2012
Last updated Jan 8th, 2024 - about 10 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720336910 NPPES
Arizona MEDICAID 204924
Arizona MEDICAID 7100218950
Arizona MEDICAID 3810025120
Arizona MEDICAID 0072341

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