Individual
MRS. MICHELLE LYNN PORTADIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN, FNP-BC
Contact information
Practice address
19 OAK GLEN LN, COLTS NECK, NJ 07722-1612
(732) 299-6576
Mailing address
19 OAK GLEN LN, COLTS NECK, NJ 07722-1612
(732) 299-6576
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26NJ01056000
NJ
Other
Enumeration date
11/04/2020
Last updated
11/04/2020
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