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Individual

CASSANDRA CHRISTINE PORTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3512 S LAFOUNTAIN ST, KOKOMO, IN 46902-3803
(657) 763-1007
Mailing address
2254 SEASONS SOUTH DR UNIT 1115, CARMEL, IN 46280-1664

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001355A
IN
363A00000X
Physician Assistant
363A00000X
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
14730081
CO
05
300097298
IN
01
PA.0004348
P A LICENSE
CO
Enumeration date
11/10/2011
Last updated
05/27/2025
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