JETTA VALLE MSN PMHNP-BC FNP-B NPI 1720336910

NPI Information

Jetta Valle, MSN, PMHNP-BC, FNP-B is an addiction medicine family medicine in Mesa, AZ. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. Jetta Valle, MSN, PMHNP-BC, FNP-B NPI is 1720336910. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1705 W MAIN ST
MESA, AZ
ZIP 85201
Phone: (877) 809-5092
Fax: (480) 718-9477

The NPI 1720336910 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/21/2012 and was last updated on 1/8/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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