Individual
MICHELLE PORTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
10588 VARESE LN, NORTHGLENN, CO 80234-3687
(720) 467-6212
Mailing address
10588 VARESE LN, NORTHGLENN, CO 80234-3687
(720) 467-6212
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN.0187389
CO
Other
Enumeration date
11/15/2016
Last updated
11/15/2016
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