Individual
MARTA G POORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
3100 TONGASS AVE, KETCHIKAN, AK 99901-5746
(907) 228-7688
(907) 228-8468
Mailing address
3100 TONGASS AVE, KETCHIKAN, AK 99901-5746
(907) 228-7688
(907) 228-8468
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
82 AND 10053
AK
367A00000X
Advanced Practice Midwife
82 AND 10053
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP0082
—
AK
Enumeration date
12/21/2006
Last updated
03/05/2010
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