Individual
MRS. JETTA VALLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, PMHNP, FNP
Contact information
Practice address
21168 E OCOTILLO RD # 1271, QUEEN CREEK, AZ 85142-8175
(520) 677-8025
(888) 205-9338
Mailing address
21168 E OCOTILLO RD # 1271, QUEEN CREEK, AZ 85142-8175
(520) 677-8025
(888) 205-9338
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
AP10652
AZ
363LF0000X
Family Nurse Practitioner
AP10652
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP10652
AZ
363LP2300X
Primary Care Nurse Practitioner
AP10652
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204924
—
AZ
Enumeration date
08/21/2012
Last updated
08/24/2025
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