| NPI | 1174140289 |
|---|---|
| Former Name | ASHLEY MARIE PORTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024179893) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: FL 9338725) |
| Enumeration Date | 2020-07-06 |
| Last Update Date | 2021-04-01 |