Healthcare Provider Details

I. General information

NPI: 1629299052
Provider Name (Legal Business Name): STEPHANY PORTER N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 HARRY S TRUMAN PKWY STE 108
ANNAPOLIS MD
21401-7580
US

IV. Provider business mailing address

323 BAY FRONT DR
PASADENA MD
21122-6203
US

V. Phone/Fax

Practice location:
  • Phone: 410-923-8888
  • Fax:
Mailing address:
  • Phone: 410-923-8888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberJ0000012
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: