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General NPI Number Information
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NPI Number | 1649031584
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Entity Type | Organization
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Legal Business Name | FRONT PORCH MEDICAL, LLC
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Dates
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Enumeration Date | 01/18/2024
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Last Update Date | 02/24/2024
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Provider Practice Location Address
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Address Line | 212 E CLOVER ST
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City | HARLAN
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State | KY
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Zip | 40831-2363
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Country | US
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Telephone | 606-273-1139
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Fax |
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Provider Business Mailing Address
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Address Line | 212 E CLOVER ST
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City | HARLAN
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State | KY
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Zip | 40831-2363
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Country | US
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Telephone | 606-273-1139
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KIMBERLY MICHELE MILLER
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Credential | FNP-C
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Telephone | 606-273-1139
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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 |
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License Number State |
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