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Individual

AMY M PORTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
151 S UNIVERSITY AVE, PROVO, UT 84601-4427
(801) 851-7024
(801) 851-7063
Mailing address
151 S UNIVERSITY AVE, SUITE 1900, PROVO, UT 84601-4427
(801) 851-7042
(801) 851-7063

Taxonomy

Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
2677378-3102
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1225109063
UT
05
1891865010
UT
Enumeration date
06/17/2013
Last updated
06/17/2013
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