Individual provider · Type 1 NPI
Carla Portillo-Medrano, NP
Family Nurse Practitioner · Detroit, MI
NPI number
1124610654
Active
Practice location
5635 W Fort St
Detroit, MI 48209-3154
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 4704324069 (MI) |
| Registered Nurse | 163W00000X | 4704324069 (MI) |
Family Nurse Practitioner: Definition to come...
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About NPI 1124610654
Carla Portillo-Medrano, NP's National Provider Identifier is 1124610654, issued on Feb 5, 2021. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Detroit, MI. The record was last updated on Apr 24, 2025.