Individual
ANDREA E PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1900 BLUEGRASS AVE, SUITE 103, LOUISVILLE, KY 40215-1144
(502) 367-4500
(502) 368-8139
Mailing address
100 E LIBERTY ST STE 800, LOUISVILLE, KY 40202-1428
(502) 367-4500
(502) 368-8139
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3007063
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201039590
—
IN
05
—
7100178910
—
KY
Enumeration date
06/02/2011
Last updated
03/15/2018
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