Individual
ESTACY PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, FNP-C, PMHNP-BC
Contact information
Practice address
5121 WASHINGTON RD, EVANS, GA 30809-6448
(706) 426-1642
Mailing address
6231 FREEDOM CIR STE 2, GROVETOWN, GA 30813-1213
(757) 788-9578
Taxonomy
Speciality
Code
Description
License number
State
363LC1500X
Community Health Nurse Practitioner
53-78383-111
KS
363LF0000X
Family Nurse Practitioner
RN200693
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN200693
GA
Other
Enumeration date
02/27/2019
Last updated
07/17/2025
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