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1770103129
JENNIFER ROSE PORTER
THIEF RIVER FALLS, MN
NPI
1770103129
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: MN 7365)
Enumeration Date
2020-04-25
Last Update Date
2021-10-26
Business Address
Mrs. JENNIFER ROSE PORTER PMHNP
120 LABREE AVE S
THIEF RIVER FALLS, MN 56701-2819
Phone number: 218-683-4351
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Mailing Address
Mrs. JENNIFER ROSE PORTER PMHNP
PO BOX 5074
SIOUX FALLS, SD 57117-5074
Phone number:
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