Individual
MS. STEPHANIE PORTER PORTER MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNC, MSN, NNP
Contact information
Practice address
1935 MEDICAL DISTRICT DR, DALLAS, TX 75235-7701
(214) 456-7000
Mailing address
4213 BOULDER PARK DR, EULESS, TX 76040-8515
(817) 271-0352
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
526518
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
526518
REGISTERED NURSE/APN
TX
01
—
MAT1-0429-7749
NCC CERT.
—
Enumeration date
10/25/2006
Last updated
12/07/2009
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