Individual
MRS. KAYLA RENEE DWELLE PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, APRN, FNP-BC
Contact information
Practice address
550 UNIVERSITY BLVD, INDIANAPOLIS, IN 46202
(317) 944-7728
(317) 274-2940
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28191509A
IN
363L00000X
Nurse Practitioner
7100767A
IN
363LF0000X
Family Nurse Practitioner
Primary
71007167A
IN
Other
Enumeration date
01/26/2017
Last updated
01/19/2022
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