Individual
PORTIA BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
424 SAVANNAH RD, LEWES, DE 19958-1462
(302) 645-3606
Mailing address
720 STAGHORN DR, NEW CASTLE, DE 19720-7650
(859) 684-3940
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
L1-0044095
DE
Other
Enumeration date
05/12/2016
Last updated
05/12/2016
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