Female

Gretchen E. Porter RN, CNP, LAC

Adult Health Nurse Practitioner in Minneapolis, MN(View on Map)

Full Name

Gretchen Evanne Porter RN, CNP, LAC

NPI Number

1558372953

NPI Type

Individual Provider

Gender

Female

Enumeration Date

08/10/2006

Specialties

(Taxonomies)

Code

363LA2200X
171100000X

Primary Taxonomy

Yes
No

Licenses

State

Minnesota
Minnesota

License Number

R0713753
1305

Contact
Information

Purpose

Mailing
Location

Address

5208 BLOOMINGTON AVE
5208 BLOOMINGTON AVE

City

Minneapolis
Minneapolis

State

MN
MN

Postal Code

55417-1820
55417-1820

Country

US
US

Telephone Number

N/A
(612) 916-0774

Identifiers

Identifier

4927427-00

Identifier State

MN

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 05/20/2008

Provider Address

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