Healthcare Provider Details

I. General information

NPI: 1689597288
Provider Name (Legal Business Name): KADEN NICOLE PORTER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 E FRANKLIN ST
BLOOMFIELD IA
52537-1685
US

IV. Provider business mailing address

208 E FRANKLIN ST
BLOOMFIELD IA
52537-1685
US

V. Phone/Fax

Practice location:
  • Phone: 641-664-3100
  • Fax:
Mailing address:
  • Phone: 641-664-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number25619
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number25619
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: