Individual
CARRIE ELLEN VALLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1495 TEAKWOOD AVE, COOS BAY, OR 97420-2146
(208) 999-6010
Mailing address
1495 TEAKWOOD AVE, COOS BAY, OR 97420-2146
(208) 999-6010
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10017963
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500826662
—
OR
Enumeration date
09/22/2022
Last updated
11/12/2024
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