Individual
JUANITA M. VALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MSN, ANP-C
Contact information
Practice address
3851 N RIVER RD, INDIANA VETERANS' HOME, WEST LAFAYETTE, IN 47906-3762
(765) 463-1502
(765) 497-8639
Mailing address
1034 W 800 S, LAFAYETTE, IN 47909-8915
(765) 538-3099
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
67915
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
225210S
MEDICARE PIN/PTAN
IN
Enumeration date
05/17/2006
Last updated
02/07/2012
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