| Doctor Name: | MS. LAURIE LEE PORTER |
| NPI Number: | 1619021078 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 4704150368 |
| Business Practice Address: | 8288 Portage St. Onekama, MI - 49675 |
| Business Phone Number: | 2318894283 |
| Business Fax Number: | 2318894484 |
| Mailing Address: | 8288 Portage St., ONEKAMA |
| State: | MI |
| Postal Code: | 49675 |
| Phone Number: | 2318894283 |
| Fax Number: | 2318894484 |
| NPI Enumeration Date: | 01/23/2007 |
| NPI Last Update Date: | 09/20/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 4704150368 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |