Individual
JANESA PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, CPNP AC/PC
Contact information
Practice address
100 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
(801) 487-0451
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
9796639-4405
UT
363LP0200X
Pediatric Nurse Practitioner
SP026647
PA
Other
Enumeration date
11/22/2022
Last updated
01/23/2026
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