Individual
BETH ANN PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
515 MAIN ST, OLEAN, NY 14760-1513
(716) 375-7317
(716) 375-7319
Mailing address
PO BOX 708760, SANDY, UT 84070-8760
(801) 352-9500
(801) 352-7976
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
565200
NY
Other
Enumeration date
03/01/2018
Last updated
03/01/2018
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