Individual
JENNIFER KELLY PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 726-3030
Mailing address
57 PILGRIM RD, HOLLISTON, MA 01746-2422
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
117377
MA
Other
Enumeration date
06/05/2017
Last updated
01/19/2018
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