Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | R038081 | ME |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 038081 | ME |
N | 363LF0000X | Nurse Practitioner - Family Medicine | R038081 | ME |
NPI | 1003917501 |
---|---|
Provider Name | Mrs. Nancy A Porr |
First Address | Topsham, ME 04086 |
Second Address | Topsham, ME 04086 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 21/01/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
63840203 | TRADING PARTNER IDENTIFIC (01) | ME |