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Individual

MRS. DENISE ANNE SAMPLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
834 SHERIDAN ST, PORT TOWNSEND, WA 98368
(360) 385-2200
Mailing address
834 SHERIDAN ST, PORT TOWNSEND, WA 98368-2443
(360) 385-2200

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5005063
NC
363LF0000X
Family Nurse Practitioner
Primary
5005063
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7005925
NC
Enumeration date
01/26/2011
Last updated
05/29/2019
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