Doctor Name: | CINDY MEARS PORTER |
NPI Number: | 1659739571 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | 9169350 |
Business Practice Address: | 20370 Ne Burns Ave Blountstown, FL - 324241045 |
Business Phone Number: | 8506745411 |
Business Fax Number: | |
Mailing Address: | 18383 Ne County Road 274, ALTHA |
State: | FL |
Postal Code: | 324213374 |
Phone Number: | 8506438597 |
Fax Number: | |
NPI Enumeration Date: | 02/05/2016 |
NPI Last Update Date: | 02/05/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP2300X |
License Number: | 9169350 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |