Individual
MARYCLARE PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2095 N DOLORES RD, CORTEZ, CO 81321-8924
(970) 564-8086
(970) 564-8087
Mailing address
6405 S 3000 E STE 300, SALT LAKE CITY, UT 84121-6977
(801) 266-3113
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
1013532
TX
363LF0000X
Family Nurse Practitioner
Primary
APN.0999429-NP
CO
Other
Enumeration date
09/22/2020
Last updated
02/05/2024
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