Individual
MS. JEAN ELIZABETH PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
1 PINE WEST PLZ, WASHINGTON AVE EXT, ALBANY, NY 12205-5531
(518) 464-9999
(518) 464-9650
Mailing address
21 KEELER DR, ALBANY, NY 12208-1926
(518) 458-2150
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F301963
NY
Other
Enumeration date
06/28/2006
Last updated
07/08/2007
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