Individual
MRS. LAURA L PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
615 DERBY ST, ATTENTION: HCS HI&R, CHATTANOOGA, TN 37404-1632
(423) 493-2906
(423) 493-2950
Mailing address
615 DERBY ST, ATTENTION: HCS HI&R, CHATTANOOGA, TN 37404-1632
(423) 493-2906
(423) 493-2950
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
70783
TN
363LP2300X
Primary Care Nurse Practitioner
Primary
APN0000006060
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3902601
—
TN
01
—
4020701
BLUE CROSS BLUE SHIELD
TN
01
—
P33828
RR MEDICARE
TN
Enumeration date
08/12/2005
Last updated
02/12/2013
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