Individual
MRS. KEEVIA Y PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
920 MADISON AVE, MEMPHIS, TN 38163-8240
(901) 448-6134
Mailing address
5517 HERITAGE LAKE CV, MEMPHIS, TN 38109-7473
(901) 643-1540
(901) 398-2699
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0000013460
TN
Other
Enumeration date
06/03/2008
Last updated
12/03/2013
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