Individual
PORSCHE DEHUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1650 COWLES ST, FAIRBANKS, AK 99701-5907
(907) 452-8181
Mailing address
1057 WOODBURN HAY RD, HOPKINSVILLE, KY 42240-8204
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001280108
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
234507
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1755868
—
AK
Enumeration date
02/14/2025
Last updated
06/12/2025
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