Individual
ELIZABETH ANN PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
5001 STATESMAN DR, IRVING, TX 75063-2414
(800) 685-2272
(972) 983-0293
Mailing address
1000 EAST 24TH STREET, KANSAS CITY, MO 64108
(816) 404-5315
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
T-052686
IA
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
2009009752
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0446278
—
IA
01
—
37358
WELLMARK
IA
Enumeration date
10/05/2006
Last updated
06/08/2010
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