Individual
DR. JENNIFER ANN PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, CNM
Contact information
Practice address
610 30TH AVE W, ALEXANDRIA, MN 56308-3426
(320) 763-2540
Mailing address
610 30TH AVE W, ALEXANDRIA, MN 56308-3426
(320) 763-5123
(320) 763-7883
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649513979
NPI
MN
05
—
1649513979
—
MN
01
—
R-145018-3
RN LICENSE
MN
Enumeration date
04/04/2013
Last updated
08/08/2014
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