| NPI | 1285936377 |
|---|---|
| Former Name | LISA M PORTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71003460A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71003460A) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3007272) | |
| Enumeration Date | 2010-11-23 |
| Last Update Date | 2018-04-11 |