Individual
JAIMEY BLUE PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
173 SAINT PATRICKS DR STE 104, WALDORF, MD 20603-5530
(301) 818-1206
(301) 381-9655
Mailing address
173 SAINT PATRICKS DR # 224, WALDORF, MD 20603-5529
(240) 602-3085
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
201319Y11
MD
Other
Enumeration date
11/04/2022
Last updated
07/01/2024
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