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Individual

CARISSA PORTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
4750 E GALBRAITH RD, SUITE 210, CINCINNATI, OH 45236-6705
(513) 686-4830
(513) 686-4836
Mailing address
4750 E GALBRAITH RD, SUITE 210, CINCINNATI, OH 45236-6705
(513) 686-4830
(513) 686-4836

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
09046
OH
363LA2200X
Adult Health Nurse Practitioner
Primary
NP09046
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2727606
OH
Enumeration date
12/15/2006
Last updated
09/16/2011
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