Individual
ALEXANDRA H PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
777 HEMLOCK ST, MACON, GA 31201-2102
(478) 633-1531
Mailing address
777 HEMLOCK ST, MSC 118, MACON, GA 31201-2102
(478) 633-1531
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN191445
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN191445
RN LICENSE NUMBER
GA
Enumeration date
07/03/2014
Last updated
08/18/2020
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