MEDICARE: NANCY ELIZABETH PORTER CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	ARNP2523642	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	990013416	OTHER	FL	RR MCR
2	G2145	OTHER	FL	BCBS FL
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902871270
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY ELIZABETH PORTER CRNA

Provider Business Mailing Address
First Line	:	684B MIDWAY DR
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34472-8542
Country	:	US
Telephone Number	:	352-680-0385
Fax Number	:

Provider Business Practice Location Address
First Line	:	684B MIDWAY DR
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34472-8542
Country	:	US
Telephone Number	:	352-680-0385
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	07/02/2014

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