Individual
NATASHA E PORTER
Active
Individual
NATASHA E PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10001011A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000656388
ANTHEM
IN
01
—
000000741054
ANTHEM
IN
01
—
P01157122
RR MEDICARE
IN
01
—
P01751324
RR MEDICARE
IN
Enumeration date
07/11/2008
Last updated
12/28/2020
Update your record
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