Provider Demographics
NPI:1720885270
Name:FRETZ, VALERIE ANN
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:ANN
Last Name:FRETZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:
Other - Last Name:LOVELESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:215 GABRIELLE CIR
Mailing Address - Street 2:
Mailing Address - City:BETHALTO
Mailing Address - State:IL
Mailing Address - Zip Code:62010-2595
Mailing Address - Country:US
Mailing Address - Phone:217-851-5071
Mailing Address - Fax:
Practice Address - Street 1:6828 STATE ROUTE 162 STE B
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62062-8558
Practice Address - Country:US
Practice Address - Phone:618-391-5148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.031789363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily