Individual
MALLORIE PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, IBCLC
Contact information
Practice address
522 POTTS ST, DAVIDSON, NC 28036-8406
(704) 997-9406
(704) 896-4907
Mailing address
522 POTTS ST, DAVIDSON, NC 28036-8406
(704) 997-9406
(704) 896-4907
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
255956
NC
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
L-306361
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
255956
RN
NC
01
—
L-306361
IBCLC
NC
Enumeration date
07/05/2022
Last updated
07/05/2022
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