Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 242697 | AZ |
NPI | 1033706213 |
---|---|
Provider Name | Christin Porro |
First Address | Tucson, AZ 85715-3027 |
Second Address | Tucson, AZ 85715-3027 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2020 |
Last Update Date | 22/12/2020 |