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Individual
KRISTIN RAE PORTER
Active
Individual
KRISTIN RAE PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
R178637
MD
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
R178637
MD
Other
Enumeration date
08/13/2020
Last updated
05/17/2021
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