Provider Demographics
NPI:1447983069
Name:PORTILLO, SARAH LOUISE (DNP, FNP-C)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:LOUISE
Last Name:PORTILLO
Suffix:
Gender:F
Credentials:DNP, FNP-C
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Mailing Address - Street 1:501 QUERETARO DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-2721
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4815 ALAMEDA AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2705
Practice Address - Country:US
Practice Address - Phone:915-544-1200
Practice Address - Fax:915-521-7554
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-01
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1071213363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty