JASON EDWARD PORTELL

BONNE TERRE, MO
NPI1457896664
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: MO  2016044204)
Enumeration Date2016-12-23
Last Update Date2023-08-11
Business Address
JASON EDWARD PORTELL FNP-C
7245 RAIDER RD STE C
BONNE TERRE, MO 63628-3767
Phone number: 573-358-4600
Mailing Address
JASON EDWARD PORTELL FNP-C
7245 RAIDER RD STE C
BONNE TERRE, MO 63628-3767
Phone number: 573-358-4600
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