Individual
KATHRYN PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
7276 SOUTHCREST PKWY, SOUTHAVEN, MS 38671-4760
(626) 349-6577
(662) 349-6562
Mailing address
7276 SOUTHCREST PKWY, SOUTHAVEN, MS 38671-4760
(662) 349-6577
(662) 349-6562
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
905937
MS
Other
Enumeration date
05/02/2023
Last updated
05/02/2023
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