Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VE0102X | Reproductive Endocrinologist | 042-0008516 | VT |
Y | 207VE0102X | Reproductive Endocrinologist | 8749 | NH |
NPI | 1467477380 |
---|---|
Provider Name | Dr. Misty Marie Blanchette Porter |
First Address | Lebanon, NH 03756-1000 |
Second Address | Lebanon, NH 03756-1000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2006 |
Last Update Date | 12/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0VN092 | (05) | VT |
80003976 | (05) | NH |