Individual
KIMBERLY PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25 W MAIN ST, CONWAY, NH 03818-6142
(603) 447-2111
(603) 447-1021
Mailing address
87 WASHINGTON ST, CONWAY, NH 03818-6044
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
043805-21
NH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
043805-23
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043805-23
APRN
NH
Enumeration date
01/24/2023
Last updated
03/11/2023
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