Individual provider · NPI-1

Marta G Poore, ANP

Nurse Practitioner, Obstetrics & Gynecology · Ketchikan, AK

NPI number1932263043

StatusActive

Last updated in NPPESMar 5, 2010

Details

NPI: 1932263043
Entity type: Individual (NPI-1)
Name: Marta G Poore
Credential: ANP
Sex: Female
Sole proprietor: No
Enumeration date: Dec 21, 2006
Last updated: Mar 5, 2010

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
363LX0001X	Nurse Practitioner, Obstetrics & Gynecology	82 and 10053	AK	Yes
367A00000X	Advanced Practice Midwife	82 and 10053	AK

Practice location

3100 Tongass Ave
Ketchikan, AK 99901-5746

Phone 907-228-7688 · Fax 907-228-8468

Mailing address

3100 Tongass Ave
Ketchikan, AK 99901-5746

Phone 907-228-7688 · Fax 907-228-8468

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.