STEPHEN P DEPORTER

DAVENPORT, IA
NPI1639174519
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: IA  A-081354)
Enumeration Date2005-06-16
Last Update Date2021-05-06
Business Address
Mr. STEPHEN P DEPORTER APN
1227 E RUSHOLME ST
DAVENPORT, IA 52803-2459
Phone number: 563-421-1000
Mailing Address
Mr. STEPHEN P DEPORTER APN
1227 E RUSHOLME ST
DAVENPORT, IA 52803-2459
Phone number: 563-421-7681