Healthcare Provider Details

I. General information

NPI: 1396425518
Provider Name (Legal Business Name): PAULA LOUISE GLESSNER-VALLEE DNP, WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2023
Last Update Date: 07/21/2023
Certification Date: 07/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16050 N 76TH ST STE 203
SCOTTSDALE AZ
85260-1634
US

IV. Provider business mailing address

6871 E KINGS AVE
SCOTTSDALE AZ
85254-1515
US

V. Phone/Fax

Practice location:
  • Phone: 480-481-6911
  • Fax:
Mailing address:
  • Phone: 509-679-6710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number222075
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number222075
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number222075
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: