Individual
STEPHEN PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
140 ACADEMY ST, PRESQUE ISLE, ME 04769-3102
(207) 764-3142
(207) 764-6459
Mailing address
140 ACADEMY ST, PRESQUE ISLE, ME 04769-3102
(207) 764-3142
(207) 764-6459
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP081247
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053336099
—
ME
Enumeration date
07/12/2006
Last updated
11/20/2012
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