Individual
MRS. AMANDA KATHLEEN PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ACNP-BC
Contact information
Practice address
975 E 3RD ST # 376, CHATTANOOGA, TN 37403-2147
(423) 778-7234
Mailing address
1202 W MISSISSIPPI AVE, CHATTANOOGA, TN 37405-2864
(423) 503-3229
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
16873
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1529239
—
TN
Enumeration date
07/26/2012
Last updated
10/04/2018
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