Individual
KIMBERLY PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM, WHNP-BC
Contact information
Practice address
1005 W GREEN ST STE 301, HASTINGS, MI 49058-1729
(269) 945-8080
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
(616) 258-2386
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
4704246721
MI
367A00000X
Advanced Practice Midwife
Primary
4704246721
MI
Other
Enumeration date
06/09/2015
Last updated
11/29/2017
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