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AMANDA VAUGHAN PORTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
4075 OLD WESTERN ROW RD, MASON, OH 45040-3104
(513) 536-0232
Mailing address
4075 OLD WESTERN ROW RD, MASON, OH 45040-3104
(513) 536-0232

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
COA.14532-NP
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2015006538
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0085006
OH
Enumeration date
06/05/2013
Last updated
12/19/2023
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