Individual
JESSICA DENISSE PORTILLOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP-CRNA
Contact information
Practice address
1800 E VAN BUREN ST, PHOENIX, AZ 85006-3742
(602) 251-8359
Mailing address
480 S PARKCREST ST, GILBERT, AZ 85296-9517
(480) 385-8521
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA1524
AZ
Other
Enumeration date
06/05/2018
Last updated
06/05/2018
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