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1639174519
STEPHEN P DEPORTER
DAVENPORT, IA
NPI
1639174519
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IA A-081354)
Enumeration Date
2005-06-16
Last Update Date
2021-05-06
Business Address
Mr. STEPHEN P DEPORTER APN
1227 E RUSHOLME ST
DAVENPORT, IA 52803-2459
Phone number: 563-421-1000
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Mailing Address
Mr. STEPHEN P DEPORTER APN
1227 E RUSHOLME ST
DAVENPORT, IA 52803-2459
Phone number: 563-421-7681
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