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Individual

HEIDI PORTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
R.N.

Contact information

Practice address
1112 LOCUST ST, FARMINGTON, MN 55024-1793
(952) 261-6481
Mailing address
1112 LOCUST ST, FARMINGTON, MN 55024-1793

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R 214080-3
MN

Other

Enumeration date
09/01/2013
Last updated
09/01/2013
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