Individual
ELLEN KATHLEEN PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8001 YOUREE DR, SUITE 650, SHREVEPORT, LA 71115-2302
(318) 212-3787
(318) 212-3789
Mailing address
8001 YOUREE DR, SUITE 650, SHREVEPORT, LA 71115-2302
(318) 212-3787
(318) 212-3789
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP03268
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1560324
—
LA
Enumeration date
07/06/2006
Last updated
12/18/2007
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