Provider Demographics
NPI:1174698559
Name:MATTHEWS, VALERIE (CRNFA)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11219 E SHADY LN
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85749-9776
Mailing Address - Country:US
Mailing Address - Phone:520-731-1083
Mailing Address - Fax:520-207-2244
Practice Address - Street 1:11219 E SHADY LN
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85749-9776
Practice Address - Country:US
Practice Address - Phone:520-731-1083
Practice Address - Fax:520-207-2244
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN 076668163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
2437950OtherUNITED HEALTH
3570870OtherAETNA
2965198OtherCIGNA
AZ995392Medicaid
2Z4057OtherHEALTH NET
107521OtherPACIFICARE
AZAZ 0426700OtherBC & BS