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General NPI Number Information
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NPI Number | 1306072459
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Entity Type | Individual
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Provider Name | JULIE LYNN PORTER RN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/03/2009
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 4320 WORNALL RD STE 530
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City | KANSAS CITY
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State | MO
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Zip | 64111-5942
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Country | US
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Telephone | 816-932-2836
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Fax | 816-932-9868
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Provider Business Mailing Address
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Address Line | 901 E 104TH ST MAILSTOP 400
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City | KANAS CITY
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State | MO
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Zip | 64131
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Country | US
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Telephone | 816-599-9499
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Fax | 816-932-9670
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 110885
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License Number State | MO
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