Deporter, Stephen P
Deporter, Stephen P is an sole proprietor health care provider with primary practice located at 1227 E Rusholme St , Davenport IA 52803-2459. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Deporter, Stephen P can be contacted via phone (563) 421-1000.Contact Information
Primary practice address
1227 E Rusholme St
Davenport IA 52803-2459
Phone: (563) 421-1000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | A-081354 | Iowa |
Profile Details
| NPI number | 1639174519 |
|---|---|
| LBN Legal business name | Deporter, Stephen P |
| Credentials | Advanced Practice Nurse (APN) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 16th, 2005 |
| Last updated | May 6th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639174519 | NPPES |
| Other | 056857 | HEALTH ALLIANCE | |
| Other | 185922 | HEALTH ALLIANCE | |
| Other | IL01G2 | HEALTH ALLIANCE | |
| Other | 4796890020 | HEALTH ALLIANCE |
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